Andrea Madson, LMSW
Individual provider Active NPI Social Worker · Shoshone, ID
NPI 1982055166 · NPPES record last updated Jun 28, 2016
Key facts
- NPI
- 1982055166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LMSW-35813 (ID)
- Practice address
- 113 S Apple St
Shoshone, ID 83352-5287 - Phone
- (208) 886-2224
- NPI assigned
- Jun 28, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-35813 | ID | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LMSW-35813 | ID | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LMSW-35813 | ID | |
| Mental Health Counselor | 101YM0800X | LMSW-35813 | ID | |
| Social Worker | 104100000X | LMSW-35813 | ID | Yes |
| School Social Worker | 1041S0200X | LMSW-35813 | ID |
Addresses
Primary practice location
113 S Apple St
Shoshone, ID 83352-5287
Mailing address
113 S Apple St
Shoshone, ID 83352-5287
Other providers in Shoshone, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.