Phillip Hathaway, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW-38731 Issued in ID

Practice address

253 S 2ND E BSMT
Rexburg, ID 83440-2202

Phone

(253) 232-3957

NPI assigned

Jun 13, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tueller Counseling IncGroup PAC ID 0547585895, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1477766905
  Medicare reassignment Care Compare group NPD
• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rigby, ID
  • NPI 1699566356
  NPD (past)
• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rexburg, ID
  • NPI 1861283525
  NPD (past)

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1316507296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 S 2ND E BSMT",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402202",
            "telephone_number": "253-232-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 S 2ND E BSMT",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402202",
            "telephone_number": "253-232-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "PHILLIP",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-38731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Russell Hardy, D.O.
• David Thomas Hargraves, PH.D.
• Tyler Harrigfeld, DPT
• Gina G Harris, MPT
• Darren Hatch, OD
• Julie Ann Hawkins, MS, LMFT
• Stephanie Hawkins, LMSW
• Hawthorn Healing Counseling
• Rex E. Head, M.D.
• Healing Springs Counseling LLC

• Clinical Social Worker in Rexburg, ID
• Providers in Rexburg, 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 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.