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NPI Code Detail

MEDICARE: MS. KARA M KREIZENBECK LCSW

MEDICARE: MS. KARA M KREIZENBECK LCSW
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
11041C0700XClinical Social WorkerLCSW-33383ID

General Provider Information

NPI Number : 1821352378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KARA M KREIZENBECK LCSW
Provider Business Mailing Address
First Line : 10096 W FAIRVIEW AVE STE 160
Second Line :
City : BOISE
State : ID
Zip : 83704-5004
Country : US
Telephone Number : 208-908-7882
Fax Number : 208-908-7883
Provider Business Practice Location Address
First Line : 10096 W FAIRVIEW AVE STE 160
Second Line :
City : BOISE
State : ID
Zip : 83704-5004
Country : US
Telephone Number : 208-908-7882
Fax Number : 208-908-7883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2012
Last Update Date : 03/24/2026

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