Individual provider Active NPI

Maureen Kay O'Leary, LCSW

  • Clinical Social Worker
  • Nampa, ID
National Provider Identifier
1720428550
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 28110 Issued in ID
Practice address
1305 2ND St S
Suite 201
Nampa, ID 83651-3944
Phone
(208) 463-0202
Fax
(208) 463-0205
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW 28110 ID Primary

Addresses

Primary practice location

1305 2ND St S
Suite 201
Nampa, ID 83651-3944

Mailing address

1305 2ND St S
Suite 201
Nampa, ID 83651-3944
Phone (208) 463-0202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 28110IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1720428550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 2ND ST S",
            "address_2": "SUITE 201",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513944",
            "telephone_number": "208-463-0202",
            "fax_number": "208-463-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 2ND ST S",
            "address_2": "SUITE 201",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513944",
            "telephone_number": "208-463-0202",
            "fax_number": "208-463-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "MAUREEN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW 28110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.