Individual provider Active NPI

Caitlin Etain Stevens, LCSW-C

  • Clinical Social Worker
  • Coeur d'Alene, ID
National Provider Identifier
1740521038
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15123 Issued in MD
Practice address
915 W Emma Ave
Coeur D Alene, ID 83814-2531
Phone
(301) 641-0729
NPI assigned
Mar 11, 2013
Last updated
Sep 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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 15123 MD Primary

Addresses

Primary practice location

915 W Emma Ave
Coeur D Alene, ID 83814-2531

Mailing address

915 W Emma Ave
Coeur D Alene, ID 83814-2531
Phone (301) 641-0729

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
15123MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1740521038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W EMMA AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142531",
            "telephone_number": "301-641-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W EMMA AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142531",
            "telephone_number": "301-641-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CAITLIN",
        "middle_name": "ETAIN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.