Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charlotte Ann Fatafehi, LCSW

Individual provider Clinical Social Worker · NPI 1558081190

Charlotte Ann Fatafehi, LCSW is a Clinical Social Worker in Saint Anthony, Idaho. Qualified in 2022, 4 years ago. Practices with Upper Valley Community Health Services Inc, a 30-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
4
Licensed in
ID
In the registry since
2022
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

335 E Main St Ste 3
Saint Anthony, ID 83445-1546
Phone: (208) 356-4900
Fax: (208) 624-4030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 72 S 1st E Ste 103, Rexburg, ID 83440-1902 — (208) 356-4900

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 8861731 (ID)

Record details

NPI number1558081190
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 1, 2022
Last updated in NPPESAugust 14, 2025
Certification dateAugust 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Upper Valley Community Health Services Inc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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