BROOKE HERZOG (NPI# 1629402888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629402888 |
| Entity Type | Individual |
| Full Name | BROOKE HERZOG |
| Credential | LCSW |
| Practice Address |
925 Nw 1st St Meridian ID 83642 |
| Mailing Address |
777 N Raymond St Boise ID 83704-9251 |
| Practice Telephone | 2085142527 |
| Practice Fax Number | 2083752217 |
| Mailing Telephone | 2085142500 |
| Mailing Fax Number | 2083752217 |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2018-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 33040 | ID | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-37178 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1629402888 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3277 E Louise Dr Ste 220, Meridian, ID 836429390 | 2085142509 | 2083752217 |
| 915 Parkcentre Way, Suite 7, Nampa, ID 836511745 | 2084427791 |
| Street Address |
925 NW 1ST ST |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467086603 | Abundant Serenity LLC | Social Worker | 925 N Main St Ste A, Meridian, ID 83642-2301 | 2020-02-26 |
| 1124584685 | Kaitlin Cox | Social Worker | 407 South Hill Street, Meridian, TX 76665 | 2019-02-20 |
| 1194208306 | Jamie Connors | Social Worker | 3525 E Louise Dr Suite 500, Meridian, ID 83642-3555 | 2018-09-13 |
| 1811474877 | Clayton Lynn Smith | Social Worker | 2463 E Gala St Ste 100, Meridian, ID 83642-5210 | 2018-07-23 |
| 1649797705 | Katina Thomas | Social Worker | 2517 56th Ct, Meridian, MS 39305-1346 | 2017-08-29 |
| 1518481480 | Derrick Pringle | Social Worker | 110 48th Ave, Meridian, MS 39307 | 2017-08-01 |
| 1710339155 | Caroline Drummond | Social Worker | 2825 S Meridian Rd, # 150, Meridian, ID 83642-7960 | 2016-07-11 |
| 1639539927 | Cecilia Herrera | Social Worker | 2146 W Pine Ave, Meridian, ID 83642-5434 | 2016-02-29 |
| 1821489105 | Corinne Teigen | Social Worker | 5678 N Pinery Canyon Ave, Meridian, ID 83646-5809 | 2015-02-09 |
| 1205226016 | Progress Place LLC | Social Worker | 5144 Clear Creek Dr, Meridian, MS 39301-8896 | 2015-02-01 |
| Find all providers in MERIDIAN | ||||
Please comment or provide details below to improve the information on BROOKE HERZOG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.