Stephanie Marie Gallegos, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW44858 Issued in ID

Practice address

360 E Liberty St
Weiser, ID 83672-2261

Phone

(208) 549-4424

NPI assigned

Feb 6, 2020

Sex

Female

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 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.

• Weiser Valley Hospital District

  • Family Medicine Physician
  • Weiser, ID
  • NPI 1255364030
  Medicare reassignment Care Compare group NPD
• Weiser Valley Hospital District

  • Critical Access Hospital
  • Boise, ID
  • NPI 1639373772
  NPD

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1356973499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 W KANDICE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464154",
            "telephone_number": "208-871-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E LIBERTY ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722261",
            "telephone_number": "208-549-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LCSW44858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elemental Wellness & Chiropractic
• Ewc Weiser PLLC
• Family Medical Center PLLC
• Karla Fischer
• Holly Carol Freeman, CMT
• Anika Garcia
• Alicia Gonzalez
• Michelle Lynn Grendahl, LPC
• Janice Elaine Grimaldo, SLP
• Tom Gudmestad, DDS

• Social Worker in Weiser, ID
• Providers in Weiser, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.