Crystal Ipsen, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC-9578 Issued in ID

Practice address

6428 W Interchange LN
Boise, ID 83709

Phone

(208) 639-2850

Fax

(208) 593-3246

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

Yes

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1336833060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E TWIN WILLOW DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064926",
            "telephone_number": "208-639-2850",
            "fax_number": "208-593-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6428 W INTERCHANGE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-639-2850",
            "fax_number": "208-593-3246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12553 W Explorer Dr Ste 190",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837131612",
            "country_code": "US",
            "telephone_number": "208-376-7083 x1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IPSEN",
        "first_name": "CRYSTAL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LPC-9578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.