Individual provider Active NPI

Kristen L Jahnke, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1497788780
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW26978 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-3069
Fax
(208) 367-3002
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW26978 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

2316 N Cole Rd Ste a
Boise, ID 83704-7365
Phone (208) 323-2273

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

LicenseStateTypeSpecialty
LCSW26978IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Counseling Center Inc. Past Accepting new patients

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1497788780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 N COLE RD STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047365",
            "telephone_number": "208-323-2273",
            "fax_number": "208-323-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-3069",
            "fax_number": "208-367-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNKE",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW26978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.