Kimberly Lynn Hudlet, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC 2838 Issued in ID

Practice address

4700 N Cloverdale Rd
Suite 214
Boise, ID 83713-1081

Phone

(208) 376-4819

Fax

(866) 305-0713

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dirne Health Centers, Inc.

  dba Heritage Health CFHL CDA

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1194397240
  NPD (past)
• Dirne Health Centers, Inc.

  dba Heritage Family Support Services of North Idaho

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1255756730
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1104903236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 N CLOVERDALE RD STE 214",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131068",
            "telephone_number": "000-000-0000",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CLOVERDALE RD",
            "address_2": "SUITE 214",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131081",
            "telephone_number": "208-376-4819",
            "fax_number": "866-305-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDLET",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "1063004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC 2838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Shaya Huckabay
• Deanna Marie Huckabee
• Zachary Hudak
• Tracey Huddleston, PA
• Daddy Boy Huddy-Nahalea
• Holly N. Hudson-Nogle, MSW
• Angela Kathleen Hudson, LMSW
• Anna Willis Hudson, MD
• Ashley S Hudson, MK, LAT, ATC
• Jonelle Hudson, APRN-CNP

• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.