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Contact Information

SHASTA L HARDEE, LMSW-37764
2235 E 25TH ST
IDAHO FALLS, ID83404
 Phone: 208-643-2832
 Fax: 085-382-2332
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for SHASTA L HARDEE · (Female)

NPI # 1194992545
Status Active
Credentials LMSW-37764
Entity Individual
Enumeration date 05/14/2008
Last updated 06/07/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • ID License # LMSW-37764
  • ID Medicaid 002648300
  • ID Medicaid 807375600
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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