Tamara K. Pettingill, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-24477 Issued in ID

Practice address

1302 E 17TH St
Idaho Falls, ID 83404-6270

Phone

(208) 542-9199

Fax

(208) 542-6272

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pettingill Counseling Services Professional CorporationGroup PAC ID 9133598501, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pettingill Counseling Services, Professional Corporation

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1891919890

  Counselor

  Medicare reassignment Care Compare group NPD Authorized official
• Pettingill Counseling PC

  • Mental Health Counselor
  • Idaho Falls, ID
  • NPI 1770365827
  NPD Authorized official
• Pettingill Counseling Services

  • Counselor
  • Idaho Falls, ID
  • NPI 1811913676
  NPD (past) Authorized official
• Pettingill Counseling Services, PC

  • Counselor
  • Idaho Falls, ID
  • NPI 1811019904
  NPD (past) Authorized official
• Pettingill Counseling Services, Professional Corporation

  • Counselor
  • Idaho Falls, ID
  • NPI 1194847285
  NPD (past) Authorized official

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1629081864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046270",
            "telephone_number": "208-542-9199",
            "fax_number": "208-542-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046270",
            "telephone_number": "208-542-9199",
            "fax_number": "208-542-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINGILL",
        "first_name": "TAMARA",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-24477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806864000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806803500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806836700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pettingill Counseling Services
• Pettingill Counseling Services, PC
• Pettingill Counseling Services, Professional Corporation
• Pettingill Counseling Services, Professional Corporation
• Eric Vernon Pettingill, LCPC
• Robert John Pettit, MD
• David Aaron Petty, D.O.
• Kayla Suann Petty
• Wendell E Petty, M.D.
• Douglas Frank Pfister, ASLD

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, 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 Jul 24, 2026; 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.