Individual provider Active NPI

Kassidy Neighbors, LMSW

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1417680703
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
42421 Issued in ID
Practice address
148 S Cole Rd
Boise, ID 83709-0932
Phone
(208) 683-8320
NPI assigned
Jul 5, 2022
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 42421 ID Primary

Addresses

Primary practice location

148 S Cole Rd
Boise, ID 83709-0932

Mailing address

148 S Cole Rd
Boise, ID 83709-0932
Phone (208) 683-8320

Other identifiers 1

IdentifierTypeStateIssuer
ZF396428DOtherIDLICENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
42421IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Jul 10, 2022 Accepting new patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Jul 10, 2022 Accepting new patients
A New Beginning Counseling Center, PC. PastSince Jun 20, 2020 Accepting new patients

Locations

148 S Cole Rd
Boise, ID 83709
Phone (208) 683-8320

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1417680703",
    "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"
        },
        {
            "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": [],
    "basic": {
        "last_name": "NEIGHBORS",
        "first_name": "KASSIDY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "42421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "ZF396428D",
            "state": "ID"
        }
    ],
    "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 5, 2022; 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.