Active NPI
Linda K Waggoner, LPC
- Professional Counselor
- Twin Falls, ID
National Provider Identifier
1023258704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC203
- Practice address
- 493 Eastland
Twin Falls, ID 83303-0047 - Phone
- (208) 732-0995
- Fax
- (208) 732-0993
- NPI assigned
- Feb 20, 2009
- Sex
- Female
- Sole proprietor
- No
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 | LPC203 | ID | Primary |
Addresses
Primary practice location
493 Eastland
Twin Falls, ID 83303-0047
Mailing address
4265 North 1400 East
Buhl, ID 83316
Phone (208) 490-0800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805997100 | Medicaid | ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC203 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1023258704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4265 NORTH 1400 EAST",
"city": "BUHL",
"state": "ID",
"postal_code": "83316",
"telephone_number": "208-490-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "493 EASTLAND",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833030047",
"telephone_number": "208-732-0995",
"fax_number": "208-732-0993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "LINDA",
"middle_name": "K",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-20",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC203",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805997100",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.