Active NPI
Jarae Swanstrom, LCPC
- Professional Counselor
- Sandpoint, ID
National Provider Identifier
1063188183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-8294
- Practice address
- 1224 Washington Ave Ste 206
Sandpoint, ID 83864-5055 - Phone
- (208) 684-0512
- NPI assigned
- Aug 18, 2021
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC-8294 | ID | |
| Professional Counselor | 101YP2500X | LPC-8294 | ID | Primary |
Addresses
Primary practice location
1224 Washington Ave Ste 206
Sandpoint, ID 83864-5055
Mailing address
1224 Washington Ave Ste 206
Sandpoint, ID 83864-5055
Phone (208) 684-0512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 14, 2024 through Aug 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-8294 | ID | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1063188183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 WASHINGTON AVE STE 206",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838645055",
"telephone_number": "208-684-0512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 WASHINGTON AVE STE 206",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838645055",
"telephone_number": "208-684-0512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSTROM",
"first_name": "JARAE",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-18",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ID",
"license": "LPC-8294",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-8294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.