Individual provider Active NPI

Kara M Kreizenbeck, LCSW

  • Clinical Social Worker
  • Meridian, ID
National Provider Identifier
1821352378
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-33383 Issued in ID
Practice address
1941 E Blue Tick St
Meridian, ID 83642-4547
Phone
(208) 283-1443
NPI assigned
Jun 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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-33383 ID Primary

Addresses

Primary practice location

1941 E Blue Tick St
Meridian, ID 83642-4547

Mailing address

1941 E Blue Tick St
Meridian, ID 83642-4547
Phone (208) 283-1443

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
I20140130000071 ID Practitioner - Clinical Social Worker 4082843743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-33383IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Avanzar Wellness LLC CurrentSince Mar 20, 2020 Accepting new patients
Moringa Mental Health LLC Clinical Past Accepting new patients

Locations

11513 W Fairview Ave
Ste 105
Boise, ID 83713
Phone (208) 908-7882

10096 W Fairview Ave
Ste 160
Boise, ID 83704
Phone (208) 908-7882

Organizations & group practices 2

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1821352378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 E BLUE TICK ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424547",
            "telephone_number": "208-283-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 E BLUE TICK ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424547",
            "telephone_number": "208-283-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIZENBECK",
        "first_name": "KARA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-33383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.