Ronald Kyle Sebreros I, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW-34256 Issued in ID

Practice address

2100 Alan St
Idaho Falls, ID 83404-5801

Phone

(208) 528-7655

Fax

(208) 524-9390

NPI assigned

Apr 11, 2012

Last updated

Apr 10, 2024By the provider in NPPES

Sex

Male

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, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Community Council of Idaho, Inc.Group PAC ID 6204877467, 18 clinicians

Adolpho Enterprise LLC.Group PAC ID 1254552581, 6 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adolpho Enterprise LLC.

  dba One Love Agency

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
  • NPI 1932454642
  Medicare reassignment Care Compare group NPD
• Community Council of Idaho, Inc

  • Federally Qualified Health Center (FQHC)
  • Idaho Falls, ID
  • NPI 1710925250
  Medicare reassignment Care Compare group NPD
• High Country Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1295379865
  Medicare reassignment NPD
• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  Medicare reassignment NPD
• Community Council of Idaho, Inc.

  dba Community Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Blackfoot, ID
  • NPI 1356416861
  NPD
• Community Council of Idaho, Inc.

  dba Rigby Community Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Rigby, ID
  • NPI 1710664834
  NPD
• High Country Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Douglas, WY
  • NPI 1750113882
  NPD
• Adolpho Enterprise LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
  • NPI 1063340586
  NPD (past)

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1386901627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 ALAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045801",
            "telephone_number": "208-528-7655",
            "fax_number": "208-542-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ALAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045801",
            "telephone_number": "208-528-7655",
            "fax_number": "208-524-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBREROS",
        "first_name": "RONALD",
        "middle_name": "KYLE",
        "name_suffix": "I",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LCSW-34256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kade Scott, DPT, CLT
• Lexie E Scott
• Craig D Scoville, MD
• Wyatt Seal
• Janice Kytle Seargent, MED OTR/L-ATP
• See Opportunities and Achieve Results
• See Opportunities and Achieve Results
• Cassidy Ann Seedall, CNM
• Nathan Seedall, CRNA
• Chloe Olivia Seegmiller, PA-C

• Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, 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 10, 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.