Individual provider Active NPI

Heather J Nelson, MSW

  • Clinical Social Worker
  • Twin Falls, ID
National Provider Identifier
1861414310
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-26746 Issued in ID
Practice address
451 Eastland Dr Ste 7
Twin Falls, ID 83301-7454
Phone
(208) 420-9221
Fax
(208) 737-5252
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-26746 ID Primary

Addresses

Primary practice location

451 Eastland Dr Ste 7
Twin Falls, ID 83301-7454

Mailing address

640 Cherokee LN
Twin Falls, ID 83301-6849
Phone (208) 420-9221

Other names 1

  • Miss Heather J Larsen Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-26746IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1861414310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 CHEROKEE LN",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016849",
            "telephone_number": "208-420-9221",
            "fax_number": "208-737-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 EASTLAND DR STE 7",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833017454",
            "telephone_number": "208-420-9221",
            "fax_number": "208-737-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "HEATHER",
        "middle_name": "J",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-26746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "LARSEN",
            "middle_name": "J",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.