Madison Rain Molino, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

43915 Issued in ID

Practice address

5001 Cherry Gulch LN
Emmett, ID 83617-5123

Phone

(208) 365-3437

NPI assigned

Aug 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1700367133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 E PARKCENTER BLVD # 1079",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066721",
            "telephone_number": "801-633-7314"
        },
        {
            "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": [
        {
            "address_1": "8029 S 700 E",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840700555",
            "country_code": "US",
            "telephone_number": "385-557-2183",
            "fax_number": "385-557-2189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24823 Pacific Hwy S Ste 103",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980325478",
            "country_code": "US",
            "telephone_number": "253-681-0010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1455 Dixon Ave",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800268879",
            "country_code": "US",
            "telephone_number": "303-443-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLINO",
        "first_name": "MADISON",
        "middle_name": "RAIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11939680-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "43915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mikeal Bruce Nave, DC
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• Nancy Susanne Nickerson, PT
• Novitas Academy

• 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 Jun 27, 2024; 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.