Active NPI
Garren Richard Aubrey, LMSW
- Social Worker
- Pocatello, ID
National Provider Identifier
1841743564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW35148
- Practice address
- 210 W Burnside Ave Ste a
Pocatello, ID 83202-4916 - Phone
- (208) 238-9000
- Fax
- (208) 238-9002
- NPI assigned
- Jul 28, 2016
- 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 | LMSW35148 | ID | Primary |
Addresses
Primary practice location
210 W Burnside Ave Ste a
Pocatello, ID 83202-4916
Mailing address
210 W Burnside Ave Ste a
Pocatello, ID 83202-4916
Phone (208) 238-9000
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 |
|---|---|---|---|
| LMSW35148 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialists | 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.
-
- Clinical Social Worker
- Chubbuck, ID
- NPI 1548585458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1841743564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 W BURNSIDE AVE STE A",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832024916",
"telephone_number": "208-238-9000",
"fax_number": "208-238-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W BURNSIDE AVE STE A",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832024916",
"telephone_number": "208-238-9000",
"fax_number": "208-238-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUBREY",
"first_name": "GARREN",
"middle_name": "RICHARD",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-28",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW35148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.