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

Mai Le Provencio, LCSW

Individual provider Clinical Social Worker · NPI 1821534017

Mai Le Provencio, LCSW is a Clinical Social Worker in Boise, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2017
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

7235 W Potomac Dr Ste 220
Boise, ID 83704-9133
Phone: (208) 794-9703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-34323 (ID)

Record details

NPI number1821534017
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJanuary 11, 2017
Last updated in NPPESOctober 23, 2024
Certification dateOctober 23, 2024

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