Individual provider Active NPI

Jessica Louise Baecker, LPC

  • Mental Health Counselor
  • Nampa, ID
National Provider Identifier
1265187348
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC8706 Issued in ID
Practice address
320 11TH Ave S Ste 204
Nampa, ID 83651-5074
Phone
(208) 586-2285
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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 LPC8706 ID Primary

Addresses

Primary practice location

320 11TH Ave S Ste 204
Nampa, ID 83651-5074

Mailing address

320 11TH Ave S Ste 204
Nampa, ID 83651-5074
Phone (208) 586-2285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 4, 2024 through Jan 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC8706IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1265187348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 11TH AVE S STE 204",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836515074",
            "telephone_number": "208-586-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 11TH AVE S STE 204",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836515074",
            "telephone_number": "208-586-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAECKER",
        "first_name": "JESSICA",
        "middle_name": "LOUISE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC8706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.