Provider Demographics
NPI:1942549837
Name:WEBSTER, CHARO MARIE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHARO
Middle Name:MARIE
Last Name:WEBSTER
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 1:1204 W HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-2131
Mailing Address - Country:US
Mailing Address - Phone:208-880-4678
Mailing Address - Fax:208-442-7387
Practice Address - Street 1:1204 W HUDSON AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-2131
Practice Address - Country:US
Practice Address - Phone:208-880-4678
Practice Address - Fax:208-442-7387
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW25918104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker