Individual provider Active NPI

Angela Ellen Dallolio, LMSW

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1912390683
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW-37336 Issued in ID
Practice address
6550 W Emerald St Ste 108
Boise, ID 83704-8780
Phone
(208) 342-6300
Fax
(208) 342-6301
NPI assigned
Mar 5, 2015
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW-37336 ID Primary

Addresses

Primary practice location

6550 W Emerald St Ste 108
Boise, ID 83704-8780

Mailing address

13 E Ada Ave
Meridian, ID 83642-2725
Phone (208) 342-6300

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
I20180411002660 ID Practitioner - Clinical Social Worker 6305109059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1510 W Ustick Rd
Suite 130
Meridian, ID 83646-7740
Phone (208) 495-3979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Point Counseling Clinical CurrentSince Mar 1, 2022 Accepting new patients

Locations

1510 W Ustick Rd
Ste 130
Meridian, ID 83646
Phone (208) 495-3979

Organizations & group practices 1

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": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1912390683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 E ADA AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422725",
            "telephone_number": "208-342-6300",
            "fax_number": "208-342-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 W EMERALD ST STE 108",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048780",
            "telephone_number": "208-342-6300",
            "fax_number": "208-342-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLOLIO",
        "first_name": "ANGELA",
        "middle_name": "ELLEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-37336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.