Individual provider Active NPI

Julie N Labernik-Fabela, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1376732933
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-30262 Issued in ID
Practice address
5440 W Franklin Rd Ste 108
Boise, ID 83705-6433
Phone
(208) 283-7314
Fax
(208) 228-5794
NPI assigned
Oct 19, 2007
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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 LCSW-30262 ID Primary

Addresses

Primary practice location

5440 W Franklin Rd Ste 108
Boise, ID 83705-6433

Mailing address

323 S Moonstone Way
Meridian, ID 83642-6153
Phone (208) 477-7592

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
I20100608000099 ID Practitioner - Clinical Social Worker 2769512425 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-30262IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Emmett Counseling and Psychiatric Services, LLC CurrentSince Jan 1, 2011 Accepting new patients
Emmett Counseling and Psychiatric Services, LLC CurrentSince Jan 1, 2011 Accepting new patients
Azure Stone Mental Health & Wellness LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

2007 E Quail Run Rd
#1
Emmett, ID 83617
Phone (208) 365-5445

2000 S Eagle Rd
Meridian, ID 83642
Phone (208) 539-6557

501 N 16th St
Ste 110
Payette, ID 83661
Phone (208) 642-2600

Organizations & group practices 3

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1376732933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MOONSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426153",
            "telephone_number": "208-477-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 W FRANKLIN RD STE 108",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056433",
            "telephone_number": "208-283-7314",
            "fax_number": "208-228-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABERNIK-FABELA",
        "first_name": "JULIE",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-30262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.