Shell Wamble-Fisher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW1261 Issued in ID

Practice address

1276 W River St
Suite 100
Boise, ID 83702-7066

Phone

(208) 338-4699

Fax

(208) 322-4722

NPI assigned

Jun 2, 2015

Last updated

Jun 2, 2015By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1629458914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 W RIVER ST",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027066",
            "telephone_number": "208-338-4699",
            "fax_number": "208-322-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 W RIVER ST",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027066",
            "telephone_number": "208-338-4699",
            "fax_number": "208-322-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMBLE-FISHER",
        "first_name": "SHELL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW1261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Teresa Walters, CPNP
• Stephanie Walters
• Theodore A Walters, MD
• Michael Walton, MD
• John S Waltz, M.D.
• Oksana M Wandell, RN
• Ellen Wandland
• Wang Medical, Inc.
• Feng-Ling Wang, L.AC.
• Mia B Wang, LMT

• 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 Jun 2, 2015; 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.