Healthcare Provider Details

I. General information

NPI: 1760893838
Provider Name (Legal Business Name): JOSEPH DANIEL LENIHAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4737 S AFTON PLACE SUITE A
CHUBBUCK ID
83202
US

IV. Provider business mailing address

4737 S AFTON PL STE A
CHUBBUCK ID
83202-2317
US

V. Phone/Fax

Practice location:
  • Phone: 208-417-0623
  • Fax: 208-417-0641
Mailing address:
  • Phone: 208-251-8262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-38914
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: