Donavan Alyse Fitch, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-9595 Issued in ID

Practice address

148 S Cole Rd
Boise, ID 83709-0932

Phone

(208) 683-8320

NPI assigned

Jan 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northend Wellness, LLC

  • Psychologist
  • Boise, ID
  • NPI 1306230958
  Medicare reassignment NPD
• A Body & Mind Health Services, LLC

  • Mental Health Counselor
  • Boise, ID
  • NPI 1326501305
  NPD
• A Body & Mind Health Services, LLC

  • Mental Health Counselor
  • Boise, ID
  • NPI 1891396099
  NPD
• Maitri House Yoga, LLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1689116246
  NPD (past)

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1407626138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 S COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090932",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090932",
            "telephone_number": "208-683-8320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Main Street Unit G",
            "address_purpose": "LOCATION",
            "city": "Kamiah",
            "state": "ID",
            "postal_code": "83536",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "213 N Main St Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838432700",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 S Middleton Rd",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "ID",
            "postal_code": "836446046",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "496 Shoup Ave W Ste F",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833015043",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITCH",
        "first_name": "DONAVAN",
        "middle_name": "ALYSE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-9595",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-9595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myrna Clare Fisher, APPN
• Nicole Fisher
• Robert Fisher
• Sara Kristina Fiske, FNP-C
• Fit & Function Therapy Solutions, LLC
• Hannah Fitzen
• Brigitte Fitzgerald, PHARMD
• Makale Karina Fitzgerald, LMSW
• Sally E. Fitzgerald, L.M.S.W.
• Stacy A Fitzgerald, CST

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.