Bradley Midgett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW30120 Issued in ID

Practice address

8590 W Fairview Ave Ste a
Boise, ID 83704-8320

Phone

(208) 672-0260

NPI assigned

Feb 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Abundance Behavioral Health Services Inc.

  • Developmentally Disabled Services Day Training Agency
  • Caldwell, ID
  • NPI 1669775060
  NPD (past)

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1831462001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8590 W FAIRVIEW AVE STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048320",
            "telephone_number": "208-559-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8590 W FAIRVIEW AVE STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048320",
            "telephone_number": "208-672-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDGETT",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW30120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Scott Mickelsen, CRNA
• Rilee Wong Mickelsen, PA-C
• David S Micklitz, CRNA
• Andrew Micklus
• Micron Health Clinic
• John G Migliori, MD
• Mary Kathleen Migliori, MD
• Elizabeth Machelle Migneault, RN
• Drew Stanley Miiller, NP
• Kindra Miiller, NP-C

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.