Shawn Gary Nielsen, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW 24544 Issued in ID

Practice address

1276 W River St Ste 100
Boise, ID 83702-7083

Phone

(208) 338-4699

Fax

(208) 322-4722

NPI assigned

Jun 11, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1285954313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 W RIVER ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027083",
            "telephone_number": "208-338-4699",
            "fax_number": "208-322-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 W RIVER ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027083",
            "telephone_number": "208-338-4699",
            "fax_number": "208-322-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "SHAWN",
        "middle_name": "GARY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW 24544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake D Niederhauser, MD
• Alexandra Marie Nielsen, RN, NP
• Alyson Nielsen I
• Charles Francis Nielsen II, LPC, CPSS
• David C Nielsen, MD
• Tyson Nielsen, MD
• David E Nielson, PA-C
• Kara Nielson, LCPC
• Lynnan Nielson, PHARMD
• Tiffany Marie Nielson, LPC

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.