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

MS. Tamara K. Pettingill, LCSW

Individual provider Clinical Social Worker · NPI 1629081864

MS. Tamara K. Pettingill, LCSW is a Clinical Social Worker in Idaho Falls, Idaho. Qualified in 1999, 27 years ago. Practices with Pettingill Counseling Services Professional Corporation, a 2-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
27
Licensed in
ID
In the registry since
2006
Specialties on file
2
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

1302 E 17th St
Idaho Falls, ID 83404-6270
Phone: (208) 542-9199
Fax: (208) 542-6272
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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-24477 (ID)
Clinical Social Worker Taxonomy 1041C0700X

Record details

NPI number1629081864
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedAugust 15, 2006
Last updated in NPPESJuly 24, 2026
Certification dateJuly 24, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Pettingill Counseling Services Professional Corporation — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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