Individual provider Active NPI

Brandi Michelle Merrill, LCSW

  • Clinical Social Worker
  • Pocatello, ID
National Provider Identifier
1407053812
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-37508 Issued in ID
Practice address
200 S Main St
Ste P3
Pocatello, ID 83204-3261
Phone
(208) 406-9107
NPI assigned
Jun 29, 2007
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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-37508 ID Primary

Addresses

Primary practice location

200 S Main St
Ste P3
Pocatello, ID 83204-3261

Mailing address

200 S Main St
Ste P3
Pocatello, ID 83204-3261
Phone (208) 406-9107

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
I20220427003116 ID Practitioner - Clinical Social Worker 7810384658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1175 Call PL
Suite 100L
Pocatello, ID 83201-4990
Phone (208) 406-9107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Linking Resources, LLC Social Worker CurrentSince Jan 1, 2022 Accepting new patients
Wildflower Wellness, LLC CurrentSince Mar 3, 2024 Accepting new patients

Locations

1175 Call Pl
Ste 100L
Pocatello, ID 83201
Phone (208) 406-9107

200 S Main St
Ste P3
Pocatello, ID 83204
Phone (208) 251-6789

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1407053812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "address_2": "STE P3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043261",
            "telephone_number": "208-406-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "address_2": "STE P3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043261",
            "telephone_number": "208-406-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "BRANDI",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-02-14",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-37508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.