Individual provider Active NPI

Carlie Michelle Horrocks

  • Social Worker
  • Pocatello, ID
National Provider Identifier
1669831889
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
32449 Issued in ID
Practice address
1023 Yellowstone Ave
Suite J
Pocatello, ID 83201-4478
Phone
(208) 233-1276
Fax
(208) 233-0835
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 32449 ID Primary

Addresses

Primary practice location

1023 Yellowstone Ave
Suite J
Pocatello, ID 83201-4478

Mailing address

1023 Yellowstone Ave
Suite J
Pocatello, ID 83201-4478
Phone (208) 233-1276

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
32449IDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Sage Services LLC Social Worker PastSince Jan 1, 2024 Accepting new patients
Alliance Home Health of Idaho, LLC Past Accepting new patients

Organizations & group practices 2

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": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1669831889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 YELLOWSTONE AVE",
            "address_2": "SUITE J",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014478",
            "telephone_number": "208-233-1276",
            "fax_number": "208-233-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 YELLOWSTONE AVE",
            "address_2": "SUITE J",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014478",
            "telephone_number": "208-233-1276",
            "fax_number": "208-233-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORROCKS",
        "first_name": "CARLIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "32449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.