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

Marie Theresa Shackelford, LCSW

Individual provider Clinical Social Worker · NPI 1174068217

Marie Theresa Shackelford, LCSW is a Clinical Social Worker in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2016.

Licensed in
ID
In the registry since
2016
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

600 N Robbins Rd
Boise, ID 83702-4565
Phone: (208) 385-3245
Fax: (208) 489-4053
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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 LCSW36042 (ID)

Record details

NPI number1174068217
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 28, 2016
Last updated in NPPESDecember 28, 2016

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