IndividualActive
Eric Fernelius, LCSW
NPI 1154545093 · Clinical Social Worker · Rexburg, ID
Provider details
- NPI number
- 1154545093
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- 41939 (TX)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
339 E 7th N
Rexburg, ID 83440-5124
Phone: (801) 510-4750
Street-level locationGet directions
Mailing address
339 E 7th N
Rexburg, ID 83440-5124
Additional practice locations (1)
- 1100 W Jackson RdCarrollton, TX 75006-1316Phone: (972) 242-2182Fax: (972) 242-2932
Registry dates
- Enumerated
- 2007-04-12
- Last updated
- 2022-05-05
- Certified
- 2022-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.