=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629931621
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNAH HELEN ALBERTSON LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3881 N LEGACY COMMON AVE
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83646-3186
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-740-8684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3881 N LEGACY COMMON AVE
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83646-3186
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-740-8684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | LMSW-35417
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------