Individual provider Active NPI

Robert McIntyre, MS

  • Mental Health Counselor
  • Meridian, ID
National Provider Identifier
1346652401
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC6463 Issued in ID
Practice address
2176 E Franklin Rd Ste 100
Meridian, ID 83642-8009
Phone
(951) 236-3328
NPI assigned
May 23, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC5583 ID
Mental Health Counselor 101YM0800X LCPC6463 ID Primary

Addresses

Primary practice location

2176 E Franklin Rd Ste 100
Meridian, ID 83642-8009

Mailing address

2176 E Franklin Rd Ste 100
Meridian, ID 83642-8009
Phone (951) 236-3328

Other practice location 1

915 Parkcentere Way
Suite 7
Nampa, ID 83651
Phone (208) 442-7791

Other practice location 2

915 Parkcentere Way
Suite 7
Nampa, ID 83651
Phone (208) 442-7791

Other identifiers 1

IdentifierTypeStateIssuer
1477685550MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 25, 2024 through Jan 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LCPC6463IDMDMental Health Counselor
LPC5583IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346652401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 E FRANKLIN RD STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428009",
            "telephone_number": "951-236-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 E FRANKLIN RD STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428009",
            "telephone_number": "951-236-3328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Parkcentere Way",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "83651",
            "country_code": "US",
            "telephone_number": "208-442-7791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 Parkcentere Way",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "83651",
            "country_code": "US",
            "telephone_number": "208-442-7791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "ROBERT",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC5583",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC6463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477685550",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.