Provider Demographics
NPI:1851688683
Name:ESPINOZA, NANCY JO (LMSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JO
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:JO
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 E AVENUE C
Mailing Address - Street 2:
Mailing Address - City:JEROME
Mailing Address - State:ID
Mailing Address - Zip Code:83338-2621
Mailing Address - Country:US
Mailing Address - Phone:208-320-1569
Mailing Address - Fax:
Practice Address - Street 1:834 FALLS AVE
Practice Address - Street 2:STE 1050
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3365
Practice Address - Country:US
Practice Address - Phone:208-736-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW - 347381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical