Individual provider Active NPI

Kimberly L Bickley Lee, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1780838623
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 29363 Issued in ID
Practice address
131 Allumbaugh St
Boise, ID 83704-9204
Phone
(208) 367-3069
Fax
(208) 367-3002
NPI assigned
Nov 5, 2008
Last updated
Nov 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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 29363 ID Primary

Addresses

Primary practice location

131 Allumbaugh St
Boise, ID 83704-9204

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-3069

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 29363IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1780838623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-3069",
            "fax_number": "208-367-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ALLUMBAUGH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049204",
            "telephone_number": "208-367-3069",
            "fax_number": "208-367-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKLEY LEE",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW 29363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.