Juanita M Bair, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34721 Issued in ID

Practice address

5001 Cherry Gulch LN
Emmett, ID 83617-5123

Phone

(208) 365-3437

NPI assigned

May 7, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cherry Gulch

  • Psychiatric Residential Treatment Facility
  • Emmett, ID
  • NPI 1417199456
  NPD (past)

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1699359406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836170678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 CHERRY GULCH LN",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836175123",
            "telephone_number": "208-365-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIR",
        "first_name": "JUANITA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "34721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "juanitab@cherrygulch.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "address_1": "5001 Cherry Gulch Ln",
            "city": "Emmett",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836175123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aspen Ridge Social Services
• Ryan Atwood, PA-C
• Julie Aubuchon, COTA/L
• Merrit Aune, RPH
• Auralcare Hearing Centers of America, LLC
• Catherine A Ballard
• Steven Gerald Balle
• Jonathan Bret Barrus, D.O.
• Zachary N Bastian, MD
• Alan Robert Benson, CRNA

• Clinical Social Worker in Emmett, ID
• Providers in Emmett, 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 May 7, 2021; 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.