Individual provider Active NPI

Makale Karina Fitzgerald, LMSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1407749005
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW-45209 Issued in ID
Practice address
3050 N Lakeharbor LN Ste 248
Boise, ID 83703-6281
Phone
(208) 991-4696
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 45209 ID
Clinical Social Worker 1041C0700X LMSW-45209 ID Primary

Addresses

Primary practice location

3050 N Lakeharbor LN Ste 248
Boise, ID 83703-6281

Mailing address

1568 S Riverstone LN Apt 201
Boise, ID 83706-4070
Phone (435) 287-5242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1568 S Riverstone LN
Apt 201
Boise, ID 83706-4070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-45209IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Keys, LLC CurrentSince Jun 8, 2025 Accepting new patients

Locations

3050 N Lakeharbor Ln
Ste 248
Boise, ID 83703
Phone (208) 991-4696

2430 S Titanium Pl
Meridian, ID 83642
Phone (208) 947-6800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1407749005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 S RIVERSTONE LN APT 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064070",
            "telephone_number": "435-287-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 N LAKEHARBOR LN STE 248",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837036281",
            "telephone_number": "208-991-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MAKALE",
        "middle_name": "KARINA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "45209",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-45209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.