Colene K Meusborn, LCSW, DCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-27779 Issued in ID

Practice address

335 N Main St
Pocatello, ID 83204-3108

Phone

(208) 478-8340

Fax

(208) 478-8341

NPI assigned

Feb 15, 2007

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

Other names 1

• Colene K Russell Former name

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1669515805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2306",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062306",
            "telephone_number": "208-478-8340",
            "fax_number": "208-478-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N MAIN ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043108",
            "telephone_number": "208-478-8340",
            "fax_number": "208-478-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEUSBORN",
        "first_name": "COLENE",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LCSW, DCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-27779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLENE",
            "last_name": "RUSSELL",
            "middle_name": "K",
            "credential": "LCSW, DCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandi Michelle Merrill, LCSW
• Steven Merrill, MPT
• Rose Mesa, LMFT
• Mykayla Messenger, LMT
• Michelle Metcalf, DMD
• Ryker Lane Meyer
• Courtney Meyers
• Michael G. Summers DDS, Ms, PA
• Michael J. Gregson, M.D., P.a.
• Michael R Flandro OD PA

• Clinical Social Worker in Pocatello, ID
• Providers in Pocatello, 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 Dec 9, 2013; 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.