Active NPI
Greg Jay Watson, LPC
- Professional Counselor
- Boise, ID
National Provider Identifier
1164778478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-4876
- Practice address
- 5999 W State St
Boise, ID 83703-5059 - Phone
- (208) 853-5095
- Fax
- (208) 853-5125
- NPI assigned
- Jul 24, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-4876 | ID | Primary |
Addresses
Primary practice location
5999 W State St
Boise, ID 83703-5059
Mailing address
5999 W State St
Boise, ID 83703-5059
Phone (208) 853-5095
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-4876 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343088000000",
"number": "1164778478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5999 W STATE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837035059",
"telephone_number": "208-853-5095",
"fax_number": "208-853-5125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5999 W STATE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837035059",
"telephone_number": "208-853-5095",
"fax_number": "208-853-5125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "GREG",
"middle_name": "JAY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-24",
"last_updated": "2012-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-4876",
"primary": true
}
],
"identifiers": [],
"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 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.