Provider Demographics
NPI:1568874741
Name:EMERIZY, JENI T (LMSW)
Entity Type:Individual
Prefix:
First Name:JENI
Middle Name:T
Last Name:EMERIZY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JENI
Other - Middle Name:T
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:671 E RIVERPARK LN STE 100
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4000
Mailing Address - Country:US
Mailing Address - Phone:208-996-0965
Mailing Address - Fax:
Practice Address - Street 1:671 E RIVERPARK LN STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4000
Practice Address - Country:US
Practice Address - Phone:208-996-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW32110104100000X
ID362181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker