Casandra Dayley Serr, LSW
Individual provider Active NPI Social Worker · Blackfoot, ID
NPI 1316409337 · NPPES record last updated Apr 1, 2019
Key facts
- NPI
- 1316409337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 38343 (ID)
- Practice address
- 720 East Alice
Blackfoot, ID 83221 - Phone
- (208) 785-5872
- NPI assigned
- Apr 1, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38343 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho Dept of Health & Welfare Reg 7 Amh BF | Past | Accepting new patients | |
| Idaho Dept of Health & Welfare Reg 7 CMH P C | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 38343 | ID | Yes |
Addresses
Primary practice location
720 East Alice
Blackfoot, ID 83221
Mailing address
PO Box 129
Blackfoot, ID 83221-0129
Phone (208) 785-5872
Other providers in Blackfoot, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.