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NPI Code Detail

MEDICARE: HEIDI RAE BLOMBERG LMSW

MEDICARE: HEIDI RAE BLOMBERG LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker1771771ID

General Provider Information

NPI Number : 1467395467
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI RAE BLOMBERG LMSW
Provider Business Mailing Address
First Line : 413 W IDAHO ST STE 302
Second Line :
City : BOISE
State : ID
Zip : 83702-6066
Country : US
Telephone Number : 208-385-7233
Fax Number : 208-344-7233
Provider Business Practice Location Address
First Line : 413 W IDAHO ST STE 302
Second Line :
City : BOISE
State : ID
Zip : 83702-6066
Country : US
Telephone Number : 208-385-7233
Fax Number : 208-344-7233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ HEIDI RAE BLOMBERG LMSW” Practice Location

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