Individual provider Active NPI

Sally B Morrisroe, LCPC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1285997643
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-306 Issued in ID
Practice address
612 Scott St
Boise, ID 83705-1819
Phone
(208) 284-0365
Fax
(208) 344-6461
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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 LCPC-306 ID Primary

Addresses

Primary practice location

612 Scott St
Boise, ID 83705-1819

Mailing address

612 Scott St
Boise, ID 83705-1819
Phone (208) 284-0365

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
LCPC-306IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1285997643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SCOTT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051819",
            "telephone_number": "208-284-0365",
            "fax_number": "208-344-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SCOTT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051819",
            "telephone_number": "208-284-0365",
            "fax_number": "208-344-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISROE",
        "first_name": "SALLY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-306",
            "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 Jun 20, 2012; 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.