Theresa Lea Niederkruger, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29200 Issued in MN

Practice address

573 N Mineral Wells Ave
Meridian, ID 83642-7609

Phone

(208) 871-8468

NPI assigned

Oct 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Kuna Counseling Center

  • Community/Behavioral Health Agency
  • Kuna, ID
  • NPI 1568544047
  NPD (past)

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1316020779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "573 N MINERAL WELLS AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427609",
            "telephone_number": "208-871-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 N MINERAL WELLS AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427609",
            "telephone_number": "208-871-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERKRUGER",
        "first_name": "THERESA",
        "middle_name": "LEA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807382800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806552901",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER NUMBER",
            "identifier": "830415084 83651 A001",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Nichols, LMSW
• Tonia Marie Nicholson, CRNA
• Samantha Anne Nicolello, RDH
• Christopher Nicolet, PHARMD
• Julia Kate Niederer
• Jeffrey Nielsen, PHARMD
• Kathleen Rose Nielsen, PA
• Nielson Eyecare Professionals PC (The Eye Site)
• Ana D Nielson, OD
• Dennis Earl Nielson, O.D.

• Clinical Social Worker in Meridian, ID
• Providers in Meridian, 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 Jul 3, 2025; 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.