Individual provider Active NPI

Cathie Darlene Wick, LCSW

  • Clinical Social Worker
  • Meridian, ID
National Provider Identifier
1497961460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-28046 Issued in ID
Practice address
3732 W Pine Creek CT
Meridian, ID 83642-4216
Phone
(208) 870-7054
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCSW-28046 ID Primary

Addresses

Primary practice location

3732 W Pine Creek CT
Meridian, ID 83642-4216

Mailing address

3732 W Pine Creek CT
Meridian, ID 83642-4216
Phone (208) 870-7054

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
I20100513000306 ID Practitioner - Clinical Social Worker 5193853034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midvalley Healthcare PLLCGroup PAC ID 0749327880, 17 clinicians

Practice addresses (Care Compare)

2321 E Gala St
Suite 3
Meridian, ID 83642-7692
Phone (208) 888-5848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-28046IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Midvalley Healthcare PLLC CurrentSince Feb 1, 2010 Accepting new patients

Locations

2321 E Gala St
Ste 3
Meridian, ID 83642
Phone (208) 288-2280

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497961460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 W PINE CREEK CT",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424216",
            "telephone_number": "208-870-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 W PINE CREEK CT",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424216",
            "telephone_number": "208-870-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "CATHIE",
        "middle_name": "DARLENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-28046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.