Individual provider Active NPI

Thomas J Childers-Scott, LMSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1578050076
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW-35083 Issued in ID
Practice address
7941 W Rifleman St
Boise, ID 83704-9001
Phone
(208) 895-7950
Fax
(208) 322-0048
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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 LMSW-35083 ID Primary

Addresses

Primary practice location

7941 W Rifleman St
Boise, ID 83704-9001

Mailing address

10420 W Huntwood Dr
Boise, ID 83709-7125
Phone (208) 850-8410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: No
  • 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
I20230725003203 ID Practitioner - Clinical Social Worker 2264808336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-35083IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northend Wellness, LLC CurrentSince Jun 15, 2023 Accepting new patients
Therapeutic Heights LLC CurrentSince Jan 14, 2025 Accepting new patients
Maitri House Yoga, LLC Past Accepting new patients

Locations

1310 W Hays St
Boise, ID 83702
Phone (208) 803-5339

39 W Pine Ave
Meridian, ID 83642
Phone (208) 803-5339

2650 S Eagle Rd
Ste 110
Meridian, ID 83642
Phone (208) 994-5240

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1578050076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 W HUNTWOOD DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837097125",
            "telephone_number": "208-850-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7941 W RIFLEMAN ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049001",
            "telephone_number": "208-895-7950",
            "fax_number": "208-322-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS-SCOTT",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-35083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.