Active NPI
Susie Keeth, LSW
- Social Worker
- Boise, ID
National Provider Identifier
1679935175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LSW1411
- Practice address
- 1720 N Westgate Dr Ste a
Boise, ID 83704-7164 - Phone
- (208) 334-0979
- NPI assigned
- Mar 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LSW1411 | ID | Primary |
Addresses
Primary practice location
1720 N Westgate Dr Ste a
Boise, ID 83704-7164
Mailing address
1720 N Westgate Dr Ste a
Boise, ID 83704-7164
Phone (208) 334-0979
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 |
|---|---|---|---|
| LSW1411 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1679935175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 N WESTGATE DR STE A",
"city": "BOISE",
"state": "ID",
"postal_code": "837047164",
"telephone_number": "208-334-0979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 N WESTGATE DR STE A",
"city": "BOISE",
"state": "ID",
"postal_code": "837047164",
"telephone_number": "208-334-0979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEETH",
"first_name": "SUSIE",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-23",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LSW1411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.