Sidrah Khan Psychotherapy PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SIDRAH KHAN PSYCHOTHERAPY PC

Practice address

242 N 8TH St
Suite 200
Boise, ID 83702

Phone

(208) 447-9526

NPI assigned

May 31, 2018

Last updated

May 31, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sidrah S Khan, LCSWNPI 1386045433

Title

Owner

Phone

(208) 447-9526

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sidrah S Khan, LCSW

  • Clinical Social Worker
  • Boise, ID
  • NPI 1386045433
  NPD (past) Authorized official

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1114419678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 N NYSTROM PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N 8TH ST",
            "address_2": "SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-447-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDRAH KHAN PSYCHOTHERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SIDRAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-447-9526",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Shupperd, CPO
• Rodrigue Shyaka
• Brady Sibbett, CRNA
• Shaun Ryan Sibbett, CRNA
• Christopher Sickel
• Sherri Siegel, NP
• Meredith Ashley Sievers, AGACNP
• Jacqueline Clare Sigman, RN, BSN
• Stacey Aileen Sigmond, OTR/L
• Shanaz Sikder, MD

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.