Individual provider Active NPI

Inger M Persson, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1356496574
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-37436 Issued in ID
Practice address
131 N Allumbaugh St
Boise, ID 83704
Phone
(208) 302-0900
Fax
(208) 302-0955
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3019-C NV
Clinical Social Worker 1041C0700X LCSW-37436 ID Primary

Addresses

Primary practice location

131 N Allumbaugh St
Boise, ID 83704

Mailing address

3340 E Goldstone Way
Meridian, ID 83642
Phone (208) 302-0900

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
I20181113002468 ID Practitioner - Clinical Social Worker 3870847726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho TMSGroup PAC ID 5698100840, 6 clinicians

Practice addresses (Care Compare)

7310 W Potomac Dr
Boise, ID 83704-9153
Phone (986) 200-4290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-37436IDMDClinical Social Worker
3019-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho TMS CurrentSince Feb 1, 2022 Accepting new patients
Mark a Jepson PLLC Past Accepting new patients

Locations

2650 S Eagle Rd
Ste 100
Meridian, ID 83642
Phone (986) 200-4290

2650 S Eagle Rd
Ste 110
Meridian, ID 83642
Phone (208) 994-5240

8513 NE Hazel Dell Ave
Ste 102
Vancouver, WA 98665
Phone (800) 594-8043

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1356496574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-0900",
            "fax_number": "208-302-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N ALLUMBAUGH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-302-0900",
            "fax_number": "208-302-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSSON",
        "first_name": "INGER",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "3019-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-37436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.