Individual provider Active NPI

Richard Boyce

  • Clinical Social Worker
  • Pocatello, ID
National Provider Identifier
1336309319
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-35369 Issued in ID
Practice address
2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100
Phone
(208) 236-1600
Fax
(208) 236-6695
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LCSW-35369 ID Primary

Addresses

Primary practice location

2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100

Mailing address

2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100
Phone (208) 236-1600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171219001887 ID Practitioner - Clinical Social Worker 6901190776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Mental Health SpecialistsGroup PAC ID 1658665427, 11 clinicians

Practice addresses (Care Compare)

210 W Burnside Ave
Suite a
Pocatello, ID 83202-4916
Phone (208) 238-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-35369IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialists Professional CurrentSince Apr 17, 2016 Accepting new patients
Mental Health Specialists Social Worker Current Accepting new patients

Locations

210 W Burnside Ave
Ste A
Pocatello, ID 83202
Phone (208) 238-9000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1336309319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 GARRETT WAY",
            "address_2": "STE 1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015100",
            "telephone_number": "208-236-1600",
            "fax_number": "208-236-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 GARRETT WAY",
            "address_2": "STE 1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015100",
            "telephone_number": "208-236-1600",
            "fax_number": "208-236-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYCE",
        "first_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-35369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.