Active NPI
Rebecca L Johnston, LCSW
- Clinical Social Worker
- Garden City, ID
National Provider Identifier
1871069070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-34117
- Practice address
- 533 E Trackstand LN
Garden City, ID 83714-1614 - Phone
- (208) 860-5696
- NPI assigned
- Oct 16, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-34117 | ID | Primary |
Addresses
Primary practice location
533 E Trackstand LN
Garden City, ID 83714-1614
Mailing address
533 E Trackstand LN
Garden City, ID 83714-1614
Phone (208) 860-5696
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-34117 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1871069070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 E TRACKSTAND LN",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141614",
"telephone_number": "208-860-5696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "533 E TRACKSTAND LN",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141614",
"telephone_number": "208-860-5696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "REBECCA",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-16",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-34117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.