Active NPI
Victoria L Mecham, LCSW
- Clinical Social Worker
- Idaho Falls, ID
National Provider Identifier
1851720197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-25042
- Practice address
- 320 B St Ste 109
Idaho Falls, ID 83402-3547 - Phone
- (208) 528-5434
- Fax
- (208) 522-4364
- NPI assigned
- Nov 7, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-25042 | ID | Primary |
Addresses
Primary practice location
320 B St Ste 109
Idaho Falls, ID 83402-3547
Mailing address
118 S Stout Ave
Blackfoot, ID 83221-2943
Phone (208) 785-5810
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 |
|---|---|---|---|
| LCSW-25042 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383782400000",
"number": "1851720197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 S STOUT AVE",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832212943",
"telephone_number": "208-785-5810",
"fax_number": "208-522-4364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 B ST STE 109",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834023547",
"telephone_number": "208-528-5434",
"fax_number": "208-522-4364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MECHAM",
"first_name": "VICTORIA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-07",
"last_updated": "2013-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-25042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.