Active NPI
Lori Throckmorton, LCSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1497974174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-25100
- Practice address
- 10740 W Fairview Ave
Suite 100
Boise, ID 83713-7926 - Phone
- (208) 376-0191
- Fax
- (208) 658-6299
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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-25100 | ID | Primary |
Addresses
Primary practice location
10740 W Fairview Ave
Suite 100
Boise, ID 83713-7926
Mailing address
13647 W Annabrook Dr
Boise, ID 83713-1627
Phone (208) 412-8048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-25100 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497974174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13647 W ANNABROOK DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837131627",
"telephone_number": "208-412-8048",
"fax_number": "208-658-6299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10740 W FAIRVIEW AVE",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837137926",
"telephone_number": "208-376-0191",
"fax_number": "208-658-6299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THROCKMORTON",
"first_name": "LORI",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-25100",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.