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

Lisa J Russom, LSW

Individual provider Social Worker · NPI 1003106691

Lisa J Russom, LSW is a Social Worker in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2011.

Licensed in
ID
In the registry since
2011
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

1740 E 17th St
Idaho Falls, ID 83404-6375
Phone: (208) 313-8355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence LSW-2573 (ID)

Record details

NPI number1003106691
Entity typeIndividual (Type 1)
GenderFemale
Credentials LSW
Sole proprietorNo
NPI enumeratedApril 15, 2011
Last updated in NPPESApril 15, 2011

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