Individual provider Active NPI

Kersondra Corrine Hood, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1598278673
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-39169 Issued in ID
Practice address
8950 W Emerald St
Boise, ID 83704-4854
Phone
(208) 376-7083
NPI assigned
Nov 10, 2017
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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-36585 ID
Clinical Social Worker 1041C0700X LCSW-39169 ID Primary

Addresses

Primary practice location

8950 W Emerald St
Boise, ID 83704-4854

Mailing address

8950 W Emerald St
Boise, ID 83704-4854
Phone (208) 376-7083

Other names 1

  • Ms. Cloeie Hood Professional name

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
I20200514002555 ID Practitioner - Clinical Social Worker 0244661825 Practice locations: Meridian, ID

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1033 W Pennwood St
Meridian, ID 83642-2878

429 SW 5TH Ave
Suite 110
Meridian, ID 83642-5037
Phone (208) 409-1354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-36585IDMDSocial Worker
LCSW-39169IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1598278673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044854",
            "telephone_number": "208-376-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044854",
            "telephone_number": "208-376-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOD",
        "first_name": "KERSONDRA",
        "middle_name": "CORRINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-36585",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-39169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLOEIE",
            "last_name": "HOOD",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.