Active NPI
Blaine Colin Reilly, LCPC
- Mental Health Counselor
- Meridian, ID
National Provider Identifier
1275712481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4470
- Practice address
- 2971 E Copper Point Dr Ste 100
Meridian, ID 83642-9276 - Phone
- (208) 376-5683
- Fax
- (208) 376-5690
- NPI assigned
- Oct 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4470 | ID | Primary |
Addresses
Primary practice location
2971 E Copper Point Dr Ste 100
Meridian, ID 83642-9276
Mailing address
4048 S Iriondo Way
Boise, ID 83706-5784
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4470 | ID | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compacity Counseling, LLC | Mental Health | Current | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708041600000",
"number": "1275712481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4048 S IRIONDO WAY",
"city": "BOISE",
"state": "ID",
"postal_code": "837065784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2971 E COPPER POINT DR STE 100",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429276",
"telephone_number": "208-376-5683",
"fax_number": "208-376-5690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "BLAINE",
"middle_name": "COLIN",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-24",
"last_updated": "2024-02-16",
"certification_date": "2024-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "4470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.