Bobby Leon Pascoe Jr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LPC-9755 Issued in ID

Practice address

1706 G St
Lewiston, ID 83501-2021

Phone

(208) 751-0478

NPI assigned

Oct 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1295515898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 2ND AVE N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016162",
            "telephone_number": "208-751-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 G ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012021",
            "telephone_number": "208-751-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCOE",
        "first_name": "BOBBY",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "LPC-9755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Addiction (Substance Use Disorder) Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.