Provider Demographics
NPI:1821737941
Name:ORME, SUSAN KIRBY (LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:KIRBY
Last Name:ORME
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 E WARM SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-8141
Mailing Address - Country:US
Mailing Address - Phone:208-830-9658
Mailing Address - Fax:
Practice Address - Street 1:148 S COLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-0932
Practice Address - Country:US
Practice Address - Phone:208-683-8320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-42251104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker