Cedric Joesph Decory Jr., LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW-39243 Issued in ID

Practice address

2273 S Vista Ave Ste 190
Boise, ID 83705-7341

Phone

(208) 343-2737

NPI assigned

Dec 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northend Wellness LLCGroup PAC ID 2163720848, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northend Wellness, LLC

  • Psychologist
  • Boise, ID
  • NPI 1306230958
  Medicare reassignment Care Compare group
• Maitri House Yoga, LLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1689116246
  NPD (past)

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1619514510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 W FRANKLIN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051217",
            "telephone_number": "208-412-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 S VISTA AVE STE 190",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837057341",
            "telephone_number": "208-343-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECORY",
        "first_name": "CEDRIC",
        "middle_name": "JOESPH",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-39243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah K. Every, Psy.D., LLC
• Eugenie Debourse
• Connie Sue Debs, BA
• Wendy Decarvalho
• Barbara Decker, MS CCC SLP
• Chelsea E Dedlow, NP
• Brenda Dee, LCSW
• Eric Deegear, LMT
• Ramatoulie Deen, LMSW
• Deer Point Family Practice PC

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.