Individual provider Active NPI

Louise T Van Der Eijk, PH.D.

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1073793097
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH6495 Issued in FL
Practice address
3350 W Americana Ter Ste 320
Boise, ID 83706-2548
Phone
(208) 621-4001
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH6495 FL Primary

Addresses

Primary practice location

3350 W Americana Ter Ste 320
Boise, ID 83706-2548

Mailing address

967 E Parkcenter Blvd # 240
Boise, ID 83706-6721
Phone (208) 900-8010

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL TherapyNotes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
IMH6495FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1073793097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 E PARKCENTER BLVD # 240",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066721",
            "telephone_number": "208-900-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W AMERICANA TER STE 320",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062548",
            "telephone_number": "208-621-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER EIJK",
        "first_name": "LOUISE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH6495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TherapyNotes",
            "affiliation": "N",
            "address_1": "3350 W Americana Ter Ste 320",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837062548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.