MS. TAMARA K. PETTINGILL LCSW - NPI 1629081864 - Social Worker in Idaho Falls, ID

Q: What is Tamara Pettingill's NPI number?

The NPI number for Tamara Pettingill is 1629081864. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Q: What is Tamara Pettingill's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Tamara Pettingill was last updated on July 24, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Ms. Tamara K. Pettingill Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. TAMARA K. PETTINGILL LCSW (NPI 1629081864) is an individual clinical provider in Idaho Falls, Idaho, licensed in Idaho (LCSW-24477) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1629081864

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMS. TAMARA K. PETTINGILLCredential: LCSW

Location Address1302 E 17TH STIdaho Falls, ID 83404-6270

Mailing Address1302 E 17th StIdaho Falls, ID 83404-6270 · (208) 542-9199 · Fax (208) 542-6272

Phone(208) 542-9199

Fax(208) 542-6272

Sole ProprietorYes

Medical School CMSOtherGraduated 1999

Enumeration DateAugust 15, 2006

Last NPPES UpdateJuly 24, 20263 updates tracked since enumeration

NPPES CertifiedJuly 24, 2026

✔ NPI 1629081864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in ID · LCSW-24477

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

1302 E 17TH ST, Idaho Falls, ID 83404

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Other Identifiers 3

Medicaid806864000ID

Medicaid806803500ID

Medicaid806836700ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Tamara K. Pettingill Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527093996

PECOS Enrollment IDI20051012000496

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83404 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $52.44 – $160.17

Typical copayment $0.00 (range $13.11 – $40.04)

Most-billed visit code NA

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AHNA RACHAEL HATCH

Counselor (Mental Health)