Alexi Dimitrios Fanopoulos, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW-41913 Issued in ID

Practice address

3076 N Five Mile Rd
Boise, ID 83713-5215

Phone

(208) 376-4999

NPI assigned

Mar 8, 2022

Last updated

Mar 8, 2022By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Janelle Stauffer LCSW PLLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1841681806
  NPD

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1891442935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3076 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135215",
            "telephone_number": "208-376-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3076 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135215",
            "telephone_number": "208-376-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANOPOULOS",
        "first_name": "ALEXI",
        "middle_name": "DIMITRIOS",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-41913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Care Clinic, LLC
• Family Connection, Inc. (Family Connections, Inc.)
• Family First Home Care LLC
• Family Practice Medical
• Family Practice Residency of Idaho, Inc (Family Practice Medical Center)
• Amy Faragher, LPC
• Kaylin Faranda, MS, GC
• Susan L Farber, PHD
• Mallory Hope Faricy, MS OTR/L
• David Faris, P.T.

• Clinical Social Worker in Boise, ID
• Providers in Boise, 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 Mar 8, 2022; 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.