Elizabeth Anne Videen, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-7451 Issued in ID

Practice address

11407 W Reutzel Dr
Boise, ID 83709-4404

Phone

(208) 555-7803

NPI assigned

Mar 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1295475770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 W YOSEMITE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466832",
            "telephone_number": "208-794-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11407 W REUTZEL DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837094404",
            "telephone_number": "208-555-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDEEN",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "11470",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-7451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cymbria Arielynn Victor
• Devon Victorine
• Victory Medical Transportation
• Victory Medical Transportation, Inc.
• Victory Surgical Services PLLC
• Laura Breanna Videtich, DDS
• Cristina Maria Vieira, CSWA
• Nicholas John Vietri, M.D.
• Vigilant Counseling
• Ryan Vigilant, LPC

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.