Alphonse Mbarushimana
Social Worker in Boise, ID. Individual provider (NPI-1).
NPI number1104773779
StatusActive
Last updated in NPPESMar 12, 2026
Details
- NPI
- 1104773779
- Entity type
- Individual (NPI-1)
- Name
- Alphonse Mbarushimana
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 12, 2026
- Certification date
- Mar 12, 2026
- Last updated
- Mar 12, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | – | – | Yes |
Practice location
4980 S Tinker AveBoise, ID 83709-5326
Phone 208-801-8379 · Fax 208-801-8379
Mailing address
4980 S Tinker AveBoise, ID 83709-5326
Phone 208-801-8379
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 475 Social Worker providers in Boise · All 12,265 providers in Boise
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