Individual provider Active NPI

Paisley Cummings

  • Clinical Social Worker
  • Pocatello, ID
National Provider Identifier
1942676341
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9816492-3501 Issued in UT
Practice address
611 Wilson Ave Ste 6a
Pocatello, ID 83201-5046
Phone
(801) 362-7628
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 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 9816492-3501 UT Primary

Addresses

Primary practice location

611 Wilson Ave Ste 6a
Pocatello, ID 83201-5046

Mailing address

1576 S 500 W Ste 202
Woods Cross, UT 84010-7433
Phone (801) 406-9002

Other practice location 1

1576 S 500 W Ste 202
Woods Cross, UT 84010-7433
Phone (801) 406-9002

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
9816492-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Center for Healing CurrentSince Oct 27, 2024 Accepting new patients
Grandview Family Counseling Past Accepting new patients
Grandview Family Counseling Past Accepting new patients

Locations

611 Wilson Ave
Ste 6A
Pocatello, ID 83201
Phone (208) 254-5099

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": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1942676341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 S 500 W STE 202",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840107433",
            "telephone_number": "801-406-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WILSON AVE STE 6A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015046",
            "telephone_number": "801-362-7628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1576 S 500 W Ste 202",
            "address_purpose": "LOCATION",
            "city": "Woods Cross",
            "state": "UT",
            "postal_code": "840107433",
            "country_code": "US",
            "telephone_number": "801-406-9002",
            "fax_number": "801-294-5286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "PAISLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9816492-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.