Active NPI
Russell O'Leary, LCSW
- Clinical Social Worker
- Nampa, ID
National Provider Identifier
1962883546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-39915
- Practice address
- 1305 2ND St S
Suite 201
Nampa, ID 83651-3944 - Phone
- (208) 463-0202
- Fax
- (208) 463-0205
- NPI assigned
- Jun 9, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-39915 | ID | Primary |
| Social Worker | 104100000X | LMSW-30901 | ID |
Addresses
Primary practice location
1305 2ND St S
Suite 201
Nampa, ID 83651-3944
Mailing address
1305 2ND St S Ste 201
Nampa, ID 83651-3964
Phone (208) 463-0202
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-30901 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772064000000",
"number": "1962883546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 2ND ST S STE 201",
"city": "NAMPA",
"state": "ID",
"postal_code": "836513964",
"telephone_number": "208-463-0202",
"fax_number": "208-463-0205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 2ND ST S",
"address_2": "SUITE 201",
"city": "NAMPA",
"state": "ID",
"postal_code": "836513944",
"telephone_number": "208-463-0202",
"fax_number": "208-463-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'LEARY",
"first_name": "RUSSELL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-09",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-39915",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-30901",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.