Individual provider Active NPI

Stephen Wells, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1750973715
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8861536 Issued in ID
Practice address
12553 W Explorer Dr Ste 190
Boise, ID 83713-1612
Phone
(208) 608-9485
Fax
(208) 608-9485
NPI assigned
Feb 10, 2021
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8861536 ID Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8861536 ID

Addresses

Primary practice location

12553 W Explorer Dr Ste 190
Boise, ID 83713-1612

Mailing address

12553 W Explorer Dr Ste 190
Boise, ID 83713-1612
Phone (208) 376-7083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429002731 ID Practitioner - Clinical Social Worker 0143797928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trivium Life Services Mountain West, LLCGroup PAC ID 2163555053, 4 clinicians

Practice addresses (Care Compare)

12553 W Explorer Dr
Suite 190
Boise, ID 83713-1612
Phone (208) 376-7083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8861536IDMDAddiction (Substance Use Disorder) Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1750973715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12553 W EXPLORER DR STE 190",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131612",
            "telephone_number": "208-376-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12553 W EXPLORER DR STE 190",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131612",
            "telephone_number": "208-608-9485",
            "fax_number": "208-608-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "STEPHEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8861536",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "8861536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.