Dehra McFaddan, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

39680 Issued in ID

Practice address

211 E. Coeur D'Alene Ave
102
Coeur D Alene, ID 83814

Phone

(208) 699-6817

Fax

(208) 620-2306

NPI assigned

Jul 24, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 11, 2024 through Apr 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cultivation, LLC

  dba Cultivation Counseling

  • Community/Behavioral Health Agency
  • Coeur d'Alene, ID
  • NPI 1124466990
  NPD (past)
• Post Falls Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Post Falls, ID
  • NPI 1609691773
  NPD (past)

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1477162675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E. COEUR D'ALENE AVE",
            "address_2": "102",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-699-6817",
            "fax_number": "208-620-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E. COEUR D'ALENE AVE",
            "address_2": "102",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-699-6817",
            "fax_number": "208-620-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFADDAN",
        "first_name": "DEHRA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "39680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL LICENSE",
            "identifier": "LMSW39680",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly McDermott, FNP-BC
• Kaitlyn McDonald, PHARMD
• Shawna Richardson McDonald
• Sydney Claire McDonald
• Madeline McElroy
• Robert M McFarland, M.D.
• Stacy Dawn McFarlane, APRN
• Ann Marie McGaver, BCMHC
• Lisa Lynn McGill-Vargas, M.D.
• Carmella McGinnis, SAD

• Social Worker in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.