Individual provider Active NPI

Kelly Victoria Joelle Loehr, LCPC

  • Counselor
  • Boise, ID
National Provider Identifier
1043724065
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LCPC-7923 Issued in ID
Practice address
1075 E Park Blvd
Boise, ID 83712-7722
Phone
(208) 381-5970
NPI assigned
Nov 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LCPC-7923 ID Primary

Addresses

Primary practice location

1075 E Park Blvd
Boise, ID 83712-7722

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618003458 ID Practitioner - Mental Health Counselor 8820488042 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Mar 2, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Mar 2, 2025 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

1075 E Park Blvd
Boise, ID 83712
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1043724065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E PARK BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837127722",
            "telephone_number": "208-381-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEHR",
        "first_name": "KELLY",
        "middle_name": "VICTORIA JOELLE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-7923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.