Jennifer Lynn Porter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-43510 Issued in ID

Practice address

740 McKinley Ave
Kellogg, ID 83837-2693

Phone

(208) 783-1267

Fax

(844) 807-3782

NPI assigned

May 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennifer Jackson Former name

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

Medicare enrollment (NPD)

Enrolled

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.

• Shoshone Medical Center

  • Critical Access Hospital
  • Kellogg, ID
  • NPI 1043215437

  ID

  Medicare reassignment

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1962889477",
    "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": "208-783-1267",
            "fax_number": "844-807-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MCKINLEY AVE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372693",
            "telephone_number": "208-783-1267",
            "fax_number": "844-807-3782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "858 Commerce Drive",
            "address_purpose": "LOCATION",
            "city": "Smelterville",
            "state": "ID",
            "postal_code": "83868",
            "country_code": "US",
            "telephone_number": "208-784-4612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2205 Ironwood Place",
            "address_2": "Ste A/B",
            "address_purpose": "LOCATION",
            "city": "Coeur d Alene",
            "state": "ID",
            "postal_code": "838142785",
            "country_code": "US",
            "telephone_number": "208-664-8347",
            "fax_number": "208-664-9217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-43510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962889477",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2113084",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JACKSON",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Nansel, BA, CFSP
• Shannon Marie Nansel, PEER SUPPORT SPECIAL
• Neil Orlew Norman, DDS
• North Idaho Eye Clinics, Inc.
• Amanda Rae Olson, LCSW
• Powder Basin Associates
• Powder Basin Associates
• Powder Basin Associates
• Premier Emergency Physicians of Idaho Medical Group
• Quality Care Transport

• All providers in Kellogg, ID
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.