Active NPI
Kristina Larae Palmer, LCPC CEDS
- Mental Health Counselor
- Meridian, ID
National Provider Identifier
1447423462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4502
- Practice address
- 39 E State Ave
Meridian, ID 83642-2342 - Phone
- (208) 392-2762
- Fax
- (208) 247-0873
- NPI assigned
- Apr 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3202 | ID | |
| Mental Health Counselor | 101YM0800X | 4502 | ID | Primary |
Addresses
Primary practice location
39 E State Ave
Meridian, ID 83642-2342
Mailing address
39 E State Ave
Meridian, ID 83642-2342
Phone (208) 392-2762
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3202 | ID | MD | Addiction (Substance Use Disorder) Counselor |
| 4502 | ID | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Home Society of Idaho | Past | Accepting new patients | |
| Children'S Home Society of Idaho | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Boise, ID
- NPI 1194834010
-
- General Practice Physician
- Boise, ID
- NPI 1285971416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708905600000",
"number": "1447423462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 E STATE AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422342",
"telephone_number": "208-392-2762",
"fax_number": "208-247-0873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 E STATE AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422342",
"telephone_number": "208-392-2762",
"fax_number": "208-247-0873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "KRISTINA",
"middle_name": "LARAE",
"credential": "LCPC CEDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-10",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ID",
"license": "3202",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "4502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.