Individual provider Active NPI

Sydney Kulhanek

  • Social Worker
  • Gooding, ID
National Provider Identifier
1699493593
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LMSW-42422 Issued in ID
Practice address
605 11TH Ave E
Gooding, ID 83330-5368
Phone
(208) 934-8461
NPI assigned
Aug 16, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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 LMSW-42422 ID Primary

Addresses

Primary practice location

605 11TH Ave E
Gooding, ID 83330-5368

Mailing address

605 11TH Ave E
Gooding, ID 83330-5368
Phone (208) 934-8461

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
LMSW-42422IDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1699493593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 11TH AVE E",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833305368",
            "telephone_number": "208-934-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 11TH AVE E",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833305368",
            "telephone_number": "208-934-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULHANEK",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-42422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gooding, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.