Healthcare Provider Details

I. General information

NPI: 1972413896
Provider Name (Legal Business Name): ANDREW PARAS LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2647 KIMBERLY RD STE 2
TWIN FALLS ID
83301-7976
US

IV. Provider business mailing address

794 EASTLAND DR
TWIN FALLS ID
83301-6856
US

V. Phone/Fax

Practice location:
  • Phone: 208-734-1281
  • Fax: 208-734-1282
Mailing address:
  • Phone: 208-734-3312
  • Fax: 208-734-5036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9781628
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: