Active NPI
Walter James Meldrum, CADC, BS, QSUDP
- Addiction (Substance Use Disorder) Counselor
- Boise, ID
National Provider Identifier
1376178210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11733
- Practice address
- 3663 N Lakeharbor LN
Boise, ID 83703-6913 - Phone
- (208) 650-7359
- NPI assigned
- Mar 11, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11733 | ID | Primary |
Addresses
Primary practice location
3663 N Lakeharbor LN
Boise, ID 83703-6913
Mailing address
1682 E Time Zone Dr
Meridian, ID 83642-4500
Phone (208) 351-2765
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11733 | ID | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1376178210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1682 E TIME ZONE DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836424500",
"telephone_number": "208-351-2765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3663 N LAKEHARBOR LN",
"city": "BOISE",
"state": "ID",
"postal_code": "837036913",
"telephone_number": "208-650-7359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELDRUM",
"first_name": "WALTER",
"middle_name": "JAMES",
"credential": "CADC, BS, QSUDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-11",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ID",
"license": "11733",
"primary": true
}
],
"identifiers": [],
"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 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.