Individual provider Active NPI

Rebecca Schreiber

  • Counselor
  • Caldwell, ID
National Provider Identifier
1194361220
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-7479 Issued in ID
Practice address
1609 S Kimball Ave Ste 201
Caldwell, ID 83605-5196
Phone
(208) 899-8101
NPI assigned
Nov 25, 2019
Last updated
Jul 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-7479 ID Primary

Addresses

Primary practice location

1609 S Kimball Ave Ste 201
Caldwell, ID 83605-5196

Mailing address

294 W Trophy St
Kuna, ID 83634-3310
Phone (208) 936-1202

Other identifiers 1

IdentifierTypeStateIssuer
LPC-7479OtherIDIDAHO BOARD OF OCCUPATIONAL LICENSES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250131002465 ID Practitioner - Mental Health Counselor 3678002888 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-7479IDMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Portneuf Valley Family Center Counselor CurrentSince Jan 16, 2025 Accepting new patients

Locations

444 Hospital Way
Ste 477
Pocatello, ID 83201
Phone (208) 233-7832

15 W Center St
Ste 2
Soda Springs, ID 83276
Phone (208) 547-4470

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1194361220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 W TROPHY ST",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343310",
            "telephone_number": "208-936-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 S KIMBALL AVE STE 201",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055196",
            "telephone_number": "208-899-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHREIBER",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LPC-7479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO BOARD OF OCCUPATIONAL LICENSES",
            "identifier": "LPC-7479",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.