Individual provider Active NPI

Cynthia Daniela Annest, LCSW

  • Clinical Social Worker
  • Nampa, ID
National Provider Identifier
1578088670
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-41133 Issued in ID
Practice address
215 E Hawaii Ave # 140
Nampa, ID 83686-6011
Phone
(208) 514-2502
Fax
(208) 375-2217
NPI assigned
Aug 9, 2017
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-36910 ID
Clinical Social Worker 1041C0700X LCSW-41133 ID Primary

Addresses

Primary practice location

215 E Hawaii Ave # 140
Nampa, ID 83686-6011

Mailing address

17942 Mountain Springs Ave
Nampa, ID 83687-5114
Phone (208) 250-5700

Other practice location 1

112 12th Ave Rd
Nampa, ID 83686-5011
Phone (208) 465-5433

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
I20221021001869 ID Practitioner - Clinical Social Worker 4981070521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-36910IDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Health, Inc. CurrentSince May 18, 2022 Accepting new patients
Resilient Mental Health LLC Past Accepting new patients

Locations

777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

215 E Hawaii Ave
#140
Nampa, ID 83686
Phone (208) 514-2502

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1578088670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17942 MOUNTAIN SPRINGS AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875114",
            "telephone_number": "208-250-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE # 140",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-514-2502",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 12th Ave Rd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836865011",
            "country_code": "US",
            "telephone_number": "208-465-5433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANNEST",
        "first_name": "CYNTHIA",
        "middle_name": "DANIELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-36910",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-41133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.