Active NPI
R. Ryan O'Rourke, L.P.C.
- Professional Counselor
- Boise, ID
National Provider Identifier
1336377126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC3651
- Practice address
- 1502 W Franklin St
North End Wellness
Boise, ID 83702-4028 - Phone
- (208) 371-3671
- Fax
- (208) 344-3059
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC3651 | ID | Primary |
Addresses
Primary practice location
1502 W Franklin St
North End Wellness
Boise, ID 83702-4028
Mailing address
1502 W Franklin St
North End Wellness
Boise, ID 83702-4028
Phone (208) 371-3671
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010162257 | Other | ID | REGENTS BLUE SHIELD |
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 |
|---|---|---|---|
| LPC3651 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1336377126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 W FRANKLIN ST",
"address_2": "NORTH END WELLNESS",
"city": "BOISE",
"state": "ID",
"postal_code": "837024028",
"telephone_number": "208-371-3671",
"fax_number": "208-344-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 W FRANKLIN ST",
"address_2": "NORTH END WELLNESS",
"city": "BOISE",
"state": "ID",
"postal_code": "837024028",
"telephone_number": "208-371-3671",
"fax_number": "208-344-3059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'ROURKE",
"first_name": "R.",
"middle_name": "RYAN",
"name_prefix": "Ms.",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC3651",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENTS BLUE SHIELD",
"identifier": "000010162257",
"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 Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.