Breonna V Krafft-Harris, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-6256 Issued in ID

Practice address

911 11TH Ave S
Nampa, ID 83651-4511

Phone

(208) 371-9090

NPI assigned

Dec 12, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Breonna V Krafft Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1003527896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 11TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514511",
            "telephone_number": "208-371-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 11TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514511",
            "telephone_number": "208-371-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAFFT-HARRIS",
        "first_name": "BREONNA",
        "middle_name": "V",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-6256",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-6256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREONNA",
            "last_name": "KRAFFT",
            "middle_name": "V",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Nampa, ID
• Providers in Nampa, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.