Active NPI
Petra Morrison, LCPC, NCC
- Community/Behavioral Health Agency
- Nampa, ID
National Provider Identifier
1144544206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- LCPC 5801
- Practice address
- 1031 W. Sanetta St.
Nampa, ID 83651 - Phone
- (208) 466-7443
- NPI assigned
- Mar 18, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | LCPC 5801 | ID | Primary |
Addresses
Primary practice location
1031 W. Sanetta St.
Nampa, ID 83651
Mailing address
2273 S Vista Ave Ste 190
Boise, ID 83705-7341
Phone (208) 343-2737
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC 5801 | ID | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460678400000",
"number": "1144544206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2273 S VISTA AVE STE 190",
"city": "BOISE",
"state": "ID",
"postal_code": "837057341",
"telephone_number": "208-343-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1031 W. SANETTA ST.",
"city": "NAMPA",
"state": "ID",
"postal_code": "83651",
"telephone_number": "208-466-7443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISON",
"first_name": "PETRA",
"credential": "LCPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-18",
"last_updated": "2016-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "ID",
"license": "LCPC 5801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Apr 15, 2016; 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.