Charlotte A Fatafehi, LCSW
Individual provider Active NPI Clinical Social Worker · Saint Anthony, ID
NPI 1558081190 · NPPES record last updated Aug 11, 2026
Key facts
- NPI
- 1558081190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8861731 (ID)
- Practice address
- 335 E Main St Ste 3
Saint Anthony, ID 83445-1546 - Phone
- (208) 356-4900
- Fax
- (208) 624-4030
- NPI assigned
- Sep 1, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Upper Valley Community Health Services Inc
Practice addresses (Care Compare)
335 E Main St
Saint Anthony, ID 83445-1546
Phone (208) 356-4900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250828004317 | ID | Practitioner - Clinical Social Worker | 1456852615 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Valley Community Health Services, Inc. | Clinical | Current |
Accepting new patients |
| Upper Valley Community Health Services Inc | Current | Accepting new patients | |
| Upper Valley Community Health Services Inc | Social Worker | Current |
Accepting new patients |
| Upper Valley Community Health Services Inc | Social Worker | Past | Accepting new patients |
Locations
72 S 1st E
Ste 103
Rexburg, ID 83440
20 N 3rd E
Saint Anthony, ID 83445
Phone (208) 624-4100
335 E Main St
Ste 3
Saint Anthony, ID 83445
Phone (208) 624-4100
335 E Main St
Saint Anthony, ID 83445
Phone (208) 624-4100
335 E Main St
Ste 1
Saint Anthony, ID 83445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8861731 | ID | Yes |
Addresses
Primary practice location
335 E Main St Ste 3
Saint Anthony, ID 83445-1546
Mailing address
PO Box 18
Saint Anthony, ID 83445-0018
Phone (208) 356-4900
Other practice location 1
72 S 1st E Ste 103
Rexburg, ID 83440-1902
Phone (208) 356-4900
Other providers in Saint Anthony, ID
- Atitida Echi-Aboli
- Avery Ann Eddins
- Enhanced Physical Therapy PLLC
- Excellence in Everyone, LLC
- Expressions Supportive Services, LLC
- Fremont Family Medicine PC
- Fremont Joint School District #215
- Fremont Medical Center, PLLC
- Fremont Medical Services PC
- Fremont Physical Therapy PLLC
All providers in Saint Anthony, ID · Clinical Social Worker in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.