Lacey Jane Wuthrich, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1777 E Clark St Ste 330
Pocatello, ID 83201-3357

Phone

(208) 233-5433

Fax

(877) 284-2783

NPI assigned

Oct 20, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1982115671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 E CLARK ST STE 330",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013357",
            "telephone_number": "208-233-5433",
            "fax_number": "877-284-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 E CLARK ST STE 330",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013357",
            "telephone_number": "208-233-5433",
            "fax_number": "877-284-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUTHRICH",
        "first_name": "LACEY",
        "middle_name": "JANE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilary Worthen, LAT, ATC
• Shelby J Worthington
• Brittany Wright, LCSW
• Derek Layne Wright, MD
• Yewen Wu
• Aspin B Wyma, DC
• Drew Wyman
• Kolleen Marie Wynn-Gallipeau, CERTIFIED PEER SUPP
• Hao Yan
• Daniel Paul Yates, D.M.D.

• Social Worker in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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.