Active NPI
Sebastian David Calderon, LMSW
- Social Worker
- Burley, ID
National Provider Identifier
1639853286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6471144
- Practice address
- 1360 Albion Ave
Burley, ID 83318-1818 - Phone
- (208) 878-7008
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Social Worker | 104100000X | 6471144 | ID | Primary |
Addresses
Primary practice location
1360 Albion Ave
Burley, ID 83318-1818
Mailing address
740 W 176 LN S
Paul, ID 83347-8697
Phone (208) 650-5822
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6471144 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Beginnings Counseling | Counselor | Current | Accepting new patients |
Locations
1360 Albion Ave
Burley, ID 83318
Phone (208) 431-1399
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1639853286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 W 176 LN S",
"city": "PAUL",
"state": "ID",
"postal_code": "833478697",
"telephone_number": "208-650-5822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 ALBION AVE",
"city": "BURLEY",
"state": "ID",
"postal_code": "833181818",
"telephone_number": "208-878-7008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "SEBASTIAN",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-14",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "6471144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.