Active NPI
Tamara Wilkinson, LCSW
- Clinical Social Worker
- Burley, ID
National Provider Identifier
1457532087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-1350
- Practice address
- 1320 Bennett Ave # B
Burley, ID 83318-2665 - Phone
- (208) 678-0101
- Fax
- (208) 678-0303
- NPI assigned
- Nov 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-1350 | ID | Primary |
Addresses
Primary practice location
1320 Bennett Ave # B
Burley, ID 83318-2665
Mailing address
794 Eastland Dr
Twin Falls, ID 83301-6856
Phone (208) 734-3312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-1350 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201478400000",
"number": "1457532087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "794 EASTLAND DR",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016856",
"telephone_number": "208-734-3312",
"fax_number": "208-734-3313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 BENNETT AVE # B",
"city": "BURLEY",
"state": "ID",
"postal_code": "833182665",
"telephone_number": "208-678-0101",
"fax_number": "208-678-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "TAMARA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-26",
"last_updated": "2008-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-1350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.