Individual provider Active NPI

Shawna Teneyck, LCSW

  • Clinical Social Worker
  • Idaho Falls, ID
National Provider Identifier
1881036085
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-27824 Issued in ID
Practice address
1565 E Lincoln Rd
Idaho Falls, ID 83401-2129
Phone
(208) 524-8996
Fax
(208) 524-1205
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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-27824 ID Primary

Addresses

Primary practice location

1565 E Lincoln Rd
Idaho Falls, ID 83401-2129

Mailing address

1565 E Lincoln Rd
Idaho Falls, ID 83401-2129
Phone (208) 524-8996

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

LicenseStateTypeSpecialty
LCSW-27824IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1881036085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 E LINCOLN RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012129",
            "telephone_number": "208-524-8996",
            "fax_number": "208-524-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 E LINCOLN RD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012129",
            "telephone_number": "208-524-8996",
            "fax_number": "208-524-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENEYCK",
        "first_name": "SHAWNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-27824",
            "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 Feb 21, 2024; 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.