Individual provider Active NPI

Luis Esteban Chavolla

  • Clinical Social Worker
  • Coeur d'Alene, ID
National Provider Identifier
1902372857
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8911211 Issued in ID
Practice address
3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Phone
(208) 620-5250
NPI assigned
Oct 18, 2018
Last updated
May 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-43041 ID
Clinical Social Worker 1041C0700X 8911211 ID Primary

Addresses

Primary practice location

3700 W Seltice Way
Coeur D Alene, ID 83814-8921

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 620-5250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609000831 ID Practitioner - Clinical Social Worker 3375053473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dirne Health Centers IncGroup PAC ID 2466353354, 82 clinicians

Practice addresses (Care Compare)

3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Phone (208) 620-5255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-43041IDMDSocial Worker
8911211IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dirne Health Centers, Inc. Clinical CurrentSince May 27, 2025 Accepting new patients
Dirne Health Centers, Inc. Social Worker Current Accepting new patients
Dirne Health Centers Inc Social Worker Past Accepting new patients

Locations

1090 W Park Pl
Coeur D Alene, ID 83814
Phone (208) 215-2005

2205 N Ironwood Pl
Coeur D Alene, ID 83814
Phone (208) 292-0303

3700 W Seltice Way
Coeur D Alene, ID 83814
Phone (208) 620-5250

740 McKinley Ave
Kellogg, ID 83837
Phone (208) 783-1267

925 E Polston Ave
Post Falls, ID 83854
Phone (208) 618-0787

16760 N Highway 41
Rathdrum, ID 83858
Phone (208) 687-5627

120 S 13th St
St Maries, ID 83861
Phone (208) 245-4363

Interoperability endpoints

  • Direct secure messaging: luis.esteban.chavolla.1@16899.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1902372857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-620-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W SELTICE WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838148921",
            "telephone_number": "208-620-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVOLLA",
        "first_name": "LUIS",
        "middle_name": "ESTEBAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-18",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-43041",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8911211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.