Healthcare Provider Details

I. General information

NPI: 1972433282
Provider Name (Legal Business Name): LISA MARIE CALDER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 N CECIL RD STE 202
POST FALLS ID
83854-8966
US

IV. Provider business mailing address

9169 W STATE ST STE 3125
GARDEN CITY ID
83714-1733
US

V. Phone/Fax

Practice location:
  • Phone: 208-216-3351
  • Fax:
Mailing address:
  • Phone: 208-216-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9421136
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC70077843
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: