Active NPI
Uncil Grace Jo, LCSW
- Clinical Social Worker
- Caldwell, ID
National Provider Identifier
1639409188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-30053
- Practice address
- 2922 Cleveland Blvd Ste 500
Caldwell, ID 83605-6962 - Phone
- (208) 453-1439
- NPI assigned
- Jan 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-30053 | ID | Primary |
Addresses
Primary practice location
2922 Cleveland Blvd Ste 500
Caldwell, ID 83605-6962
Mailing address
11491 W Wagon Pass CT
Boise, ID 83709-8565
Phone (208) 345-6202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-30053 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1639409188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11491 W WAGON PASS CT",
"city": "BOISE",
"state": "ID",
"postal_code": "837098565",
"telephone_number": "208-345-6202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2922 CLEVELAND BLVD STE 500",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836056962",
"telephone_number": "208-453-1439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JO",
"first_name": "UNCIL",
"middle_name": "GRACE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-06",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-30053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.