Active NPI
Raymond Joseph Prevost, LMSW
- Social Worker
- Plummer, ID
National Provider Identifier
1831821768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-42383
- Practice address
- 427 12TH St
Plummer, ID 83851-4000 - Phone
- (208) 686-1931
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-42383 | ID | Primary |
Addresses
Primary practice location
427 12TH St
Plummer, ID 83851-4000
Mailing address
5452 N Stuart St
Coeur D Alene, ID 83815-9492
Phone (208) 661-3054
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-42383 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Hearts Mental Health Therapy | Mental Health | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Coeur D Alene, ID
- NPI 1316573819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1831821768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5452 N STUART ST",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838159492",
"telephone_number": "208-661-3054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 12TH ST",
"city": "PLUMMER",
"state": "ID",
"postal_code": "838514000",
"telephone_number": "208-686-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREVOST",
"first_name": "RAYMOND",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-42383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plummer, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.