Individual provider Active NPI

Aaron Elias St.George, B.S., CADC

  • Addiction (Substance Use Disorder) Counselor
  • Caldwell, ID
National Provider Identifier
1255813044
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11542 Issued in ID
Practice address
524 Cleveland Blvd Ste 230
Caldwell, ID 83605-4080
Phone
(208) 800-0588
Fax
(208) 800-0599
NPI assigned
Aug 29, 2018
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11542 ID Primary

Addresses

Primary practice location

524 Cleveland Blvd Ste 230
Caldwell, ID 83605-4080

Mailing address

524 Cleveland Blvd Ste 230
Caldwell, ID 83605-4080
Phone (208) 800-0588

Other identifiers 1

IdentifierTypeStateIssuer
11542OtherIDIBADCC

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
11542IDMDAddiction (Substance Use Disorder) Counselor

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1255813044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 CLEVELAND BLVD STE 230",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054080",
            "telephone_number": "208-800-0588",
            "fax_number": "208-800-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 CLEVELAND BLVD STE 230",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054080",
            "telephone_number": "208-800-0588",
            "fax_number": "208-800-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.GEORGE",
        "first_name": "AARON",
        "middle_name": "ELIAS",
        "credential": "B.S., CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "11542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBADCC",
            "identifier": "11542",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.