Organization Active NPI

Grounded Wellness PLLC

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1609702604
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GROUNDED WELLNESS PLLC
Practice address
1010 W Washington St
Boise, ID 83702-5446
Phone
(208) 860-2390
NPI assigned
Jun 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Jackelle KnickrehmNPI 1740962315
Title
Owner
Phone
(208) 860-2390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1010 W Washington St
Boise, ID 83702-5446

Mailing address

713 N Echohawk Way
Eagle, ID 83616-5489
Phone (208) 860-2390

National Provider Directory

National Provider Directory

Locations

1010 W Washington St
Boise, ID 83702
Phone (208) 854-4270

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1609702604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 N ECHOHAWK WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165489",
            "telephone_number": "208-860-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W WASHINGTON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025446",
            "telephone_number": "208-860-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUNDED WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "KNICKREHM",
        "authorized_official_first_name": "JACKELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-860-2390"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.