Active NPI
Kelly Steven Piersanti, LPC
- Professional Counselor
- Malad City, ID
National Provider Identifier
1003113390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-4594
- Practice address
- 44 N Main St
Malad City, ID 83252-1200 - Phone
- (208) 766-2389
- NPI assigned
- Feb 22, 2011
- Last updated
- Feb 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-4594 | ID | Primary |
Addresses
Primary practice location
44 N Main St
Malad City, ID 83252-1200
Mailing address
2646 N 1575 E
Layton, UT 84040-8508
Phone (801) 771-0332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-4594 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298332800000",
"number": "1003113390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2646 N 1575 E",
"city": "LAYTON",
"state": "UT",
"postal_code": "840408508",
"telephone_number": "801-771-0332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 N MAIN ST",
"city": "MALAD CITY",
"state": "ID",
"postal_code": "832521200",
"telephone_number": "208-766-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERSANTI",
"first_name": "KELLY",
"middle_name": "STEVEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-22",
"last_updated": "2011-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-4594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malad City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.