Active NPI
Andrea Leeds, LCSW
- Mental Health Counselor
- Boise, ID
National Provider Identifier
1295863157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCSW1060
- Practice address
- 1607 W Jefferson St
Boise, ID 83702-5111 - Phone
- (208) 336-5533
- Fax
- (208) 947-4290
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- Sole proprietor
- No
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 | LCSW1060 | ID | Primary |
Addresses
Primary practice location
1607 W Jefferson St
Boise, ID 83702-5111
Mailing address
1607 W Jefferson St
Boise, ID 83702-5111
Phone (208) 336-5533
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010145219 | Other | ID | REGENCEMENTALHEALTH |
| L3308 | Other | ID | BCI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW1060 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1295863157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 W JEFFERSON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837025111",
"telephone_number": "208-336-5533",
"fax_number": "208-947-4290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 W JEFFERSON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837025111",
"telephone_number": "208-336-5533",
"fax_number": "208-947-4290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEDS",
"first_name": "ANDREA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCSW1060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCEMENTALHEALTH",
"identifier": "000010145219",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCI",
"identifier": "L3308",
"state": "ID"
}
],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.