Roberta Crockett, M.A., LMFT, LCPC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT-1 Issued in ID

Practice address

1407 N 13TH St
Boise, ID 83702-3531

Phone

(208) 345-1022

Fax

(208) 433-1407

NPI assigned

Oct 15, 2006

Last updated

Nov 19, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• David a. Teed, CSWP, PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
  • NPI 1487370052
  NPD (past)

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1033209341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N 13TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023531",
            "telephone_number": "208-345-1022",
            "fax_number": "208-433-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N 13TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023531",
            "telephone_number": "208-345-1022",
            "fax_number": "208-433-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "ROBERTA",
        "credential": "M.A., LMFT, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-238",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Crites, MD
• Jessica Rose Crocker-Oswald, LCSW
• Erica Crockett, LPC, NCC
• Jayme Crockett, CPM, LM
• Madeline Crockett
• Gina M Crockford, COTA
• Gordon G Croft, D.M.D.
• Croi Care Services, LLC.
• Laura Ann Cromwell, LCPC, LMFT
• Andrew Cron, MD

• Marriage & Family Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.