Individual provider Active NPI

Karlee Leeann Boese, LCSW

  • Clinical Social Worker
  • Salmon, ID
National Provider Identifier
1568928323
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-41191 Issued in ID
Practice address
1301 Main St Ste 3B
Salmon, ID 83467-4452
Phone
(208) 756-2927
Fax
(208) 756-1518
NPI assigned
Feb 18, 2019
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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-41191 ID Primary

Addresses

Primary practice location

1301 Main St Ste 3B
Salmon, ID 83467-4452

Mailing address

1380 Benton St
Idaho Falls, ID 83401-4254
Phone (208) 523-2490

Other identifiers 1

IdentifierTypeStateIssuer
LCSW-41191OtherIDLCSW LICENSE

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
I20220404002140 ID Practitioner - Clinical Social Worker 7113313925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lemhi Valley Social Services, Inc.Group PAC ID 1355582370, 7 clinicians

Practice addresses (Care Compare)

1301 Main St
Suite 3B
Salmon, ID 83467-4452
Phone (208) 756-2927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-41191IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lemhi Valley Social Services, Inc. Social Worker CurrentSince Dec 10, 2021 Accepting new patients
Lemhi Valley Social Services, Inc. PastSince Dec 10, 2021 Accepting new patients

Locations

1380 Benton St
Idaho Falls, ID 83401
Phone (208) 403-3472

1301 Main St
Ste 3B
Salmon, ID 83467
Phone (208) 756-2927

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1568928323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 BENTON ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014254",
            "telephone_number": "208-523-2490",
            "fax_number": "208-522-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MAIN ST STE 3B",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674452",
            "telephone_number": "208-756-2927",
            "fax_number": "208-756-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOESE",
        "first_name": "KARLEE",
        "middle_name": "LEEANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-41191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "LCSW-41191",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.