Healthcare Provider Details

I. General information

NPI: 1669202362
Provider Name (Legal Business Name): AMY HILDERBRAND LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY VALADEZ LMSW

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 BLAINE ST
CALDWELL ID
83605-4343
US

IV. Provider business mailing address

PO BOX 812
CALDWELL ID
83606-0812
US

V. Phone/Fax

Practice location:
  • Phone: 208-454-3430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLMSW-45201
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: