Dylan Marshall Landeen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-42552 Issued in ID

Practice address

1810 W Broadway St
Idaho Falls, ID 83402-5072

Phone

(208) 206-7613

NPI assigned

Sep 9, 2022

Last updated

Sep 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1538880224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S CHARLOTTE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025675",
            "telephone_number": "208-206-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025072",
            "telephone_number": "208-206-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDEEN",
        "first_name": "DYLAN",
        "middle_name": "MARSHALL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-42552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Kent Lambson, LMFT
• Malory Ruth Lambson
• Trina Lambson, LCSW
• Trevor Lance
• Landbank Laboratories, LLC
• John Edward Landers, PH.D.
• Sari Jane Landers, RDN, LDN
• Jaxson Landon, DC
• Kira C Lane, LPC3502
• Robert Lang, LCPC

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.