Active NPI
Jeannie Freeman, LCSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1902230238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW--35112
- Practice address
- 500 W Idaho St Ste 204
Boise, ID 83702-5755 - Phone
- (208) 954-7739
- NPI assigned
- Aug 22, 2013
- Last updated
- Jun 14, 2023
- 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--35112 | ID | Primary |
Addresses
Primary practice location
500 W Idaho St Ste 204
Boise, ID 83702-5755
Mailing address
6957 W Ashland Dr
Boise, ID 83709-1915
Phone (208) 954-1383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 3, 2024 through Jan 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW--35112 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1902230238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6957 W ASHLAND DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837091915",
"telephone_number": "208-954-1383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W IDAHO ST STE 204",
"city": "BOISE",
"state": "ID",
"postal_code": "837025755",
"telephone_number": "208-954-7739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "JEANNIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-22",
"last_updated": "2023-06-14",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW--35112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.