Active NPI
Jennie Patricia Hazen, L.C.P.C.
- Professional Counselor
- Meridian, ID
National Provider Identifier
1033209796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-3644
- Practice address
- 3006 E Goldstone Dr
Meridian, ID 83642-1549 - Phone
- (208) 515-7661
- Fax
- (208) 908-6164
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LCPC-5665 | ID | |
| Professional Counselor | 101YP2500X | LPC-3644 | ID | Primary |
Addresses
Primary practice location
3006 E Goldstone Dr
Meridian, ID 83642-1549
Mailing address
3006 E Goldstone Dr
Meridian, ID 83642-1549
Phone (208) 515-7661
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 |
|---|---|---|---|
| LCPC-5665 | ID | MD | Professional Counselor |
| LPC-3644 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752969600000",
"number": "1033209796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3006 E GOLDSTONE DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421549",
"telephone_number": "208-515-7661",
"fax_number": "208-908-6164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3006 E GOLDSTONE DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421549",
"telephone_number": "208-515-7661",
"fax_number": "208-908-6164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEN",
"first_name": "JENNIE",
"middle_name": "PATRICIA",
"name_prefix": "Mrs.",
"credential": "L.C.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2025-07-20",
"certification_date": "2025-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC-5665",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-3644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.