Active NPI
William C Hodgson, LCSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1366465288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-1272
- Practice address
- 909 E Reserve St
Boise, ID 83712-6508 - Phone
- (208) 343-7717
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-1272 | ID | Primary |
Addresses
Primary practice location
909 E Reserve St
Boise, ID 83712-6508
Mailing address
4860 Robb St
Suite 201
Wheat Ridge, CO 80033-2184
Phone (303) 278-7418
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805622500 | Medicaid | ID | |
| P00009424 | Other | ID | RAILROAD |
| 12567375 | Other | ID | CAQH PIN |
| LCSW-1272 | Other | ID | PROFESSIONAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-1272 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381190400000",
"number": "1366465288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4860 ROBB ST",
"address_2": "SUITE 201",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332184",
"telephone_number": "303-278-7418",
"fax_number": "888-341-5050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 E RESERVE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126508",
"telephone_number": "208-343-7717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGSON",
"first_name": "WILLIAM",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2013-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-1272",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805622500",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00009424",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PIN",
"identifier": "12567375",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "LCSW-1272",
"state": "ID"
}
],
"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 Oct 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.