Active NPI
Virginia Watterson, LCSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1346586930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW43511
- Practice address
- 305 E Jefferson St
Boise, ID 83712-6231 - Phone
- (208) 345-0715
- Fax
- (208) 345-1142
- NPI assigned
- Dec 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | LCSW43511 | ID | Primary |
Addresses
Primary practice location
305 E Jefferson St
Boise, ID 83712-6231
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
1101 W Moana Ln
Suite 2
Reno, NV 89509-4775
Phone (775) 337-2394
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW43511 | ID | MD | Clinical Social Worker |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767139200000",
"number": "1346586930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 E JEFFERSON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126231",
"telephone_number": "208-345-0715",
"fax_number": "208-345-1142"
}
],
"practiceLocations": [
{
"address_1": "1101 W Moana Ln",
"address_2": "Suite 2",
"address_purpose": "LOCATION",
"city": "Reno",
"state": "NV",
"postal_code": "895094775",
"country_code": "US",
"telephone_number": "775-337-2394",
"fax_number": "775-337-9570",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATTERSON",
"first_name": "VIRGINIA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW43511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.