Alicia Jo Carrillo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8911078 Issued in ID

Practice address

265 E Chubbuck Rd
Chubbuck, ID 83202-5055

Phone

(208) 237-1711

Fax

(208) 237-9806

NPI assigned

Dec 6, 2022

Last updated

Apr 23, 2025By the provider in NPPES

Sex

Female

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

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center Counseling LLCGroup PAC ID 6709165442, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Center Counseling, LLC

  • Mental Health Counselor
  • Chubbuck, ID
  • NPI 1104374974

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1841901303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E CHUBBUCK RD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025055",
            "telephone_number": "208-237-1711",
            "fax_number": "208-237-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E CHUBBUCK RD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025055",
            "telephone_number": "208-237-1711",
            "fax_number": "208-237-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "ALICIA",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8911078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellie Cate Cameron, LPC
• Jacquelyn Cannon
• Salvador Cano Camacho, OT
• Canvi Behavioral Health PLLC
• Canvi Behavioral Health PLLC (CAnvi Behavioral Health CM/PS)
• Catherine Ann Cashmore, PHARMD
• Center Case Management & DD Services LLC
• Center Case Management and DD Services LLC
• Center Counseling
• Center Counseling PSR

• Clinical Social Worker in Chubbuck, ID
• Providers in Chubbuck, 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 Apr 23, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.