Individual provider Active NPI

Leta A. Storey, LCSW

  • Clinical Social Worker
  • Lewiston, ID
National Provider Identifier
1669712659
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW30956 Issued in ID
Practice address
422 17TH St
Lewiston, ID 83501-2526
Phone
(208) 743-4680
Fax
(208) 743-1756
NPI assigned
Feb 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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 LCSW30956 ID Primary

Addresses

Primary practice location

422 17TH St
Lewiston, ID 83501-2526

Mailing address

422 17TH Street
PO Box 2145
Lewiston, ID 83501
Phone (208) 743-4680

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

LicenseStateTypeSpecialty
LCSW30956IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1669712659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 17TH STREET",
            "address_2": "PO BOX 2145",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-743-4680",
            "fax_number": "208-743-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 17TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012526",
            "telephone_number": "208-743-4680",
            "fax_number": "208-743-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOREY",
        "first_name": "LETA",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW30956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.