Jessica Rose Crocker-Oswald, LCSW

Individual provider Active NPI Clinical Social Worker · Boise, ID

NPI 1962019513 · NPPES record last updated Jul 8, 2024

Key facts

NPI
1962019513
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44069 (ID)
Practice address
3350 W Americana Ter Ste 100-B
Boise, ID 83706-2521
Phone
(208) 392-0006
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
40036IDMDSocial Worker
44069IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Star Counseling, LLC Clinical Current
since Jul 21, 2024
Accepting new patients
Care Counseling Clinic, LLC Clinical Past
since Oct 1, 2020
Accepting new patients

Locations

1005 E Park Blvd
Boise, ID 83712
Phone (208) 515-7588

3350 W Americana Ter
Ste 100B
Boise, ID 83706
Phone (208) 392-0006

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 40036 ID
Clinical Social Worker 1041C0700X 44069 ID Yes

Addresses

Primary practice location

3350 W Americana Ter Ste 100-B
Boise, ID 83706-2521

Mailing address

4438 N Supai Ave
Meridian, ID 83646-3671
Phone (208) 392-0006

Other providers in Boise, ID

All providers in Boise, ID · Clinical Social Worker in Idaho

Sources for this page

Verify at the official NPI Registry.