Provider Demographics
NPI:1912577313
Name:ZAMORA, NEVADA F (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:NEVADA
Middle Name:F
Last Name:ZAMORA
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 1:1450 VALLEY STEPPE DR
Mailing Address - Street 2:
Mailing Address - City:BUHL
Mailing Address - State:ID
Mailing Address - Zip Code:83316-4901
Mailing Address - Country:US
Mailing Address - Phone:208-731-9710
Mailing Address - Fax:
Practice Address - Street 1:141 MORRISON ST
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5451
Practice Address - Country:US
Practice Address - Phone:208-737-0572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-38975104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty