Individual provider Active NPI

Cynthia Stocker, LCSW

  • Clinical Social Worker
  • Challis, ID
National Provider Identifier
1649571993
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW-29303 Issued in ID
Practice address
721 E Main Ave Ste 7
Challis, ID 83226-9321
Phone
(208) 940-0331
Fax
(208) 876-2669
NPI assigned
Nov 3, 2010
Reactivated
Oct 22, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LMSW-29303 ID Primary

Addresses

Primary practice location

721 E Main Ave Ste 7
Challis, ID 83226-9321

Mailing address

120 Pahsimeroi Rd
Ellis, ID 83235-2000
Phone (208) 940-0331

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

LicenseStateTypeSpecialty
LMSW-29303IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1649571993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PAHSIMEROI RD",
            "city": "ELLIS",
            "state": "ID",
            "postal_code": "832352000",
            "telephone_number": "208-940-0331",
            "fax_number": "208-756-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E MAIN AVE STE 7",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "832269321",
            "telephone_number": "208-940-0331",
            "fax_number": "208-876-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKER",
        "first_name": "CYNTHIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2026-10-22",
        "certification_date": "2022-09-01",
        "deactivation_date": "2022-09-01",
        "reactivation_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-29303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Challis, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; 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.