Active NPI
Susan Kleene Barnes, MA, LCPC
- Mental Health Counselor
- Boise, ID
National Provider Identifier
1053436618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCPC-3722
- Practice address
- 1414 W Franklin St
Boise, ID 83702-5023 - Phone
- (208) 343-2730
- NPI assigned
- Mar 20, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCPC-3722 | ID | Primary |
| Mental Health Counselor | 101YM0800X | LMFT-4010 | ID |
Addresses
Primary practice location
1414 W Franklin St
Boise, ID 83702-5023
Mailing address
1414 W Franklin St
Boise, ID 83702-5023
Phone (208) 343-2730
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010155402 | Other | ID | REGENCE BLUE SHIELD OF ID |
| X6885 | Other | ID | BLUE CROSS OF IDAHO |
| 820516860 | Other | ID | NGS AMERICAN INC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC-3722 | ID | MD | Mental Health Counselor |
| LMFT-4010 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291161600000",
"number": "1053436618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 W FRANKLIN ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837025023",
"telephone_number": "208-343-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 W FRANKLIN ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837025023",
"telephone_number": "208-343-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNES",
"first_name": "SUSAN",
"middle_name": "KLEENE",
"credential": "MA, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2010-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCPC-3722",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LMFT-4010",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010155402",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "X6885",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NGS AMERICAN INC",
"identifier": "820516860",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.