Shauna Lynn Staufenberg

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-43071 Issued in ID

Practice address

963 S Orchard St Ste 103
Boise, ID 83705-1917

Phone

(208) 794-1134

Fax

(208) 342-1696

NPI assigned

Mar 2, 2023

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BRC Mental Health Services

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1982126264
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 2, 2023.

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1295434876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 9TH AVE N",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 S ORCHARD ST STE 103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051917",
            "telephone_number": "208-794-1134",
            "fax_number": "208-342-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFENBERG",
        "first_name": "SHAUNA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-43071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9630",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Starrs, PA-C
• State of Idaho
• State of Idaho
• State of Idaho Department of Health and Welfare
• State of Idaho Department of Health and Welfare
• Amanda L Stauffer, PA
• Khayman Stauffer
• Kristian Lamar Stauffer, HA-2752 NBC #8040
• Braden M Stauts, DDS
• Stay Care Life Services

• All providers in Boise, ID
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.