Active NPI
Gail Ingra Peterson, M.S, LCPC
- Professional Counselor
- Nampa, ID
National Provider Identifier
1114355757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-5336
- Practice address
- 320 11TH Ave S Ste 204
Nampa, ID 83651-5074 - Phone
- (208) 871-7040
- Fax
- (208) 908-6164
- NPI assigned
- Oct 16, 2013
- 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-6750 | ID | |
| Professional Counselor | 101YP2500X | LPC-5336 | ID | Primary |
Addresses
Primary practice location
320 11TH Ave S Ste 204
Nampa, ID 83651-5074
Mailing address
320 11TH Ave S Ste 204
Nampa, ID 83651-5074
Phone (208) 871-7040
Other practice location 1
3043 S Meridian Rd
suite 125
Meridian, ID 83642-7922
Phone (208) 884-0033
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Nampa | Direct |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC-6750 | ID | MD | Mental Health Counselor |
| LPC-5336 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1114355757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 11TH AVE S STE 204",
"city": "NAMPA",
"state": "ID",
"postal_code": "836515074",
"telephone_number": "208-871-7040",
"fax_number": "208-908-6164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 11TH AVE S STE 204",
"city": "NAMPA",
"state": "ID",
"postal_code": "836515074",
"telephone_number": "208-871-7040",
"fax_number": "208-908-6164"
}
],
"practiceLocations": [
{
"address_1": "3043 S Meridian Rd",
"address_2": "suite 125",
"address_purpose": "LOCATION",
"city": "Meridian",
"state": "ID",
"postal_code": "836427922",
"country_code": "US",
"telephone_number": "208-884-0033",
"fax_number": "208-884-5258",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "GAIL",
"middle_name": "INGRA",
"credential": "M.S, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-16",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCPC-6750",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-5336",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Nampa",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "320 11th Ave S Ste 204",
"city": "Nampa",
"state": "ID",
"country_code": "US",
"postal_code": "836515074",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.