Colleen M Gingerich, LPC
Individual provider Active NPI Social Worker · Mountain Home, ID
NPI 1467572974 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1467572974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LSW-610 (ID)
- Practice address
- 47589 State Highway 78
Mountain Home, ID 83647-5081 - Phone
- (208) 845-2868
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-3380 | ID | MD | Mental Health Counselor |
| LSW-610 | ID | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-3380 | ID | |
| Social Worker | 104100000X | LSW-610 | ID | Yes |
Addresses
Primary practice location
47589 State Highway 78
Mountain Home, ID 83647-5081
Mailing address
47589 State Highway 78
Mountain Home, ID 83647-5081
Phone (208) 845-2868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC-3380 | Other | ID | LICENSED PROFESSIONAL COU |
| LSW-610 | Other | ID | LICENSED SOCIAL WORKER |
Other providers in Mountain Home, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.