Healthcare Provider Details

I. General information

NPI: 1508551730
Provider Name (Legal Business Name): MEGAN K STRICKLAND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN SPOFFORD

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 MCKENNA DR
MOUNTAIN HOME ID
83647-2143
US

IV. Provider business mailing address

190 E BANNOCK ST
BOISE ID
83712-6241
US

V. Phone/Fax

Practice location:
  • Phone: 208-587-9703
  • Fax: 208-587-1816
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8911259
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: