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

Shandra Blacker, LMSW

Individual provider Clinical Social Worker · NPI 1063892750

Shandra Blacker, LMSW is a Clinical Social Worker in Idaho Falls, Idaho. Qualified in 2015, 11 years ago. Practices with Mountain View Hospital LLC, a 267-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
11
Licensed in
ID
In the registry since
2015
What do these letters mean?
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

2275 W Broadway St Ste G
Idaho Falls, ID 83402-2902
Phone: (208) 524-7400
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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 34857 (ID)

Record details

NPI number1063892750
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW
Sole proprietorNo
NPI enumeratedJune 8, 2015
Last updated in NPPESJune 8, 2015
Mailing address2275 W Broadway St Ste G, Idaho Falls, ID 83402-2902

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Mountain View Hospital Llc — 267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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