Avalon Noel Taylor Derlacki Prentiss, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8331165 Issued in ID

Practice address

1407 N 13TH St
Boise, ID 83702-3531

Phone

(208) 207-8889

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Catalyst Counseling and Wellness LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1265202675
  NPD Authorized official

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1174196299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N 13TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N 13TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023531",
            "telephone_number": "208-207-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERLACKI PRENTISS",
        "first_name": "AVALON",
        "middle_name": "NOEL TAYLOR",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "8331165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.catalystboise.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "1015 W Hays St Ste 102",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837025412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office",
            "address_1": "1015 W Hays St Ste 102",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837025412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dentistry for Children
• Dentistry One of Idaho PC
• Dentists of Boise and Orthodontics, PC
• Rebecca Lynn Deppen, RN
• Derek Derkacs, PA-C
• Mary K Derlacki, FNP
• Dermaclinical, Inc.
• Olga Derman, M.D.
• Dermatology Clinic of Idaho
• David Deroin, MD

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.