Individual provider Active NPI

Rebecca Nelson Mumm, LCSW

  • Clinical Social Worker
  • Rexburg, ID
National Provider Identifier
1376139667
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8861508 Issued in ID
Practice address
343 E 4TH N Ste 235
Rexburg, ID 83440-6009
Phone
(208) 243-9526
Fax
(208) 366-1969
NPI assigned
Dec 21, 2020
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8861508 ID Primary

Addresses

Primary practice location

343 E 4TH N Ste 235
Rexburg, ID 83440-6009

Mailing address

665 W Main St
Rexburg, ID 83440-1889
Phone (208) 351-3086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: No
  • 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
I20260317001700 ID Practitioner - Clinical Social Worker 0446733505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2519 N 2200
Farr West, UT 84404-9301

343 E 4TH
Suite 129
Rexburg, ID 83440-6004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-40249IDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Connection CurrentSince Feb 27, 2026 Accepting new patients
North Point Counseling Clinical PastSince Dec 27, 2020 Accepting new patients

Locations

343 E 4th N
Ste 128
Rexburg, ID 83440
Phone (208) 351-3086

343 E 4th N
Ste 129
Rexburg, ID 83440
Phone (208) 357-3104

343 E 4th N
Ste 235
Rexburg, ID 83440

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1376139667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 W MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401889",
            "telephone_number": "208-351-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E 4TH N STE 235",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834406009",
            "telephone_number": "208-243-9526",
            "fax_number": "208-366-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMM",
        "first_name": "REBECCA",
        "middle_name": "NELSON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8861508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.