Individual provider Active NPI

Kristine Ann Kirsch, MCOUN., LPC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1174816680
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-4044 Issued in ID
Practice address
3350 W Americana Ter
Suite #215
Boise, ID 83706-2521
Phone
(208) 830-8658
Fax
(208) 342-0667
NPI assigned
May 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-4044 ID Primary

Addresses

Primary practice location

3350 W Americana Ter
Suite #215
Boise, ID 83706-2521

Mailing address

541 S Canvasback Way
Meridian, ID 83642-3715
Phone (208) 830-8658

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

LicenseStateTypeSpecialty
LPC-4044IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1174816680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 S CANVASBACK WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423715",
            "telephone_number": "208-830-8658",
            "fax_number": "208-342-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W AMERICANA TER",
            "address_2": "SUITE #215",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062521",
            "telephone_number": "208-830-8658",
            "fax_number": "208-342-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCH",
        "first_name": "KRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MCOUN., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-4044",
            "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 Nov 6, 2013; 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.