Individual provider Active NPI

Katherine Wannetta Kapua Whiting, LMFT, MS

  • Marriage & Family Therapist
  • Boise, ID
National Provider Identifier
1164059549
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
11439605-3902 Issued in UT
Practice address
1655 W Fairview Ave Ste 209
Boise, ID 83702-5190
Phone
(208) 352-0490
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 11439605-3902 UT Primary

Addresses

Primary practice location

1655 W Fairview Ave Ste 209
Boise, ID 83702-5190

Mailing address

207 E 40TH St TRLR 6
Garden City, ID 83714-6386
Phone (208) 352-0490

Other identifiers 3

IdentifierTypeStateIssuer
LMFT-8397OtherIDMFT LICENSE NUMBER
MFT.0002602OtherCOMFT LICENSE NUMBER
11439605-3902OtherUTMFT LICENSE NUMBER

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

LicenseStateTypeSpecialty
11439605-3902UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Valley Therapy, LLC Marriage & Family Therapist CurrentSince Jul 21, 2024 Accepting new patients

Locations

1655 W Fairview Ave
Ste 209
Boise, ID 83702
Phone (208) 352-0343

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1164059549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E 40TH ST TRLR 6",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837146386",
            "telephone_number": "208-352-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 W FAIRVIEW AVE STE 209",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025190",
            "telephone_number": "208-352-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "KATHERINE",
        "middle_name": "WANNETTA KAPUA",
        "credential": "LMFT, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "11439605-3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT LICENSE NUMBER",
            "identifier": "LMFT-8397",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT LICENSE NUMBER",
            "identifier": "MFT.0002602",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT LICENSE NUMBER",
            "identifier": "11439605-3902",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.