Mary L. Muckelroy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8861451 Issued in ID

Practice address

2825 S Meridian Rd # 150
Meridian, ID 83642-7960

Phone

(208) 297-9495

NPI assigned

Mar 8, 2021

Last updated

Sep 17, 2025By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dr Wall & Associates, LLC

  • Clinical Social Worker
  • Meridian, ID
  • NPI 1154952901
  NPD

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1437744885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 MANGO DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165123",
            "telephone_number": "972-822-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 S MERIDIAN RD # 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427960",
            "telephone_number": "208-297-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKELROY",
        "first_name": "MARY",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8861451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain West Spine LLC
• Mountain West Sport and Spine Physical Therapy LLC
• Hannah Lynn Mower
• Rachael Ann Mower, RN
• Molly Moyer, LPC
• Kristi L Mueller, LCSW
• Lesley Mueller
• Thaaer Naghaf Muhammed
• Alexis Shayne Muir
• Bradley D Mulkey, PA

• Clinical Social Worker in Meridian, ID
• Providers in Meridian, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.