Fulfillment LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FULFILLMENT LLC

Practice address

14331 Crego St
Caldwell, ID 83607-4815

Phone

(208) 290-0075

NPI assigned

Jan 11, 2023

Organization subpart

No

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

Authorized official

Name

Kendra Jean Nielson, LPCNPI 1891447751

Title

Counselor

Phone

(208) 757-0067

Specialties & licenses 1

Addresses

Tax ID family

Fulfillment LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fulfillment LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Caldwell, ID
  • NPI 1679287296
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kendra Jean Nielson

  • Mental Health Counselor
  • Meridian, ID
  • NPI 1891447751
  NPD Authorized official

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1346954658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14331 CREGO ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836074815",
            "telephone_number": "208-284-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14331 CREGO ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836074815",
            "telephone_number": "208-290-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULFILLMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "NIELSON",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "208-757-0067",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keven Freeman, DMD
• Amie J Fries, RN
• Rachelle C. Friesen, NP-C
• Linnae Frisby, NP
• Jessica Elaine Fu, M.D.
• Fulfillment LLC
• Full Circle Health, Inc. (Full Circle Health Pharmacy Caldwell)
• Chelsea Fuller, CCC-SLP
• John Fulmore, LCSW
• Molly Gallegos, MA, OTR/L

• Mental Health Counselor in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.