Individual provider Active NPI

Susan C Brown, LMSW

  • Social Worker
  • Twin Falls, ID
National Provider Identifier
1477837698
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
30820 Issued in ID
Practice address
414 Shoup Ave W
Sutie B
Twin Falls, ID 83301-5042
Phone
(208) 814-9100
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 30820 ID Primary

Addresses

Primary practice location

414 Shoup Ave W
Sutie B
Twin Falls, ID 83301-5042

Mailing address

1373 Fillmore St
Twin Falls, ID 83301-3392
Phone (208) 814-9100

Other identifiers 1

IdentifierTypeStateIssuer
1477837698MedicaidID

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
I20180228001911 ID Practitioner - Clinical Social Worker 1254692593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
KH Counseling and Health Center, LLCGroup PAC ID 6800144742, 2 clinicians

Practice addresses (Care Compare)

101 Empty Saddle TRL
Suite 120
Hailey, ID 83333-8437
Phone (208) 928-7507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30820IDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways of Idaho, LLC CurrentSince Jan 4, 2021 Accepting new patients
Carbonate Recovery Center, Inc PastSince May 7, 2024 Accepting new patients

Locations

204 10th Ave S
Nampa, ID 83651
Phone (208) 461-6523

10304 Spotsylvania Ave
Ste 300
Fredericksburg, VA 22408
Phone (540) 710-6085

Organizations & group practices 3

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": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1477837698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 FILLMORE ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013392",
            "telephone_number": "208-814-9100",
            "fax_number": "208-814-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SHOUP AVE W",
            "address_2": "SUTIE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015042",
            "telephone_number": "208-814-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SUSAN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "30820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477837698",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.