Active NPI
Theotosca Page, LCSW
- Social Worker
- Boise, ID
National Provider Identifier
1518269836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 30631
- Practice address
- 890 N Cole Rd
Boise, ID 83704-8638 - Phone
- (208) 287-2564
- Fax
- (208) 287-2570
- NPI assigned
- Nov 18, 2010
- Last updated
- Feb 11, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 30631 | ID | Primary |
Addresses
Primary practice location
890 N Cole Rd
Boise, ID 83704-8638
Mailing address
890 N Cole Rd
Boise, ID 83704-8638
Phone (208) 287-2564
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30631 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1518269836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "890 N COLE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837048638",
"telephone_number": "208-287-2564",
"fax_number": "208-287-2570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 N COLE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837048638",
"telephone_number": "208-287-2564",
"fax_number": "208-287-2570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "THEOTOSCA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-18",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "30631",
"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 Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.