Elisabeth Pederson, LPC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

545 N Benjamin LN
Boise, ID 83704-9623

Phone

(208) 322-1026

NPI assigned

Sep 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Pathways of Idaho, LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1326466988
  NPD

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1578286407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S WHIPOORWILL WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091369",
            "telephone_number": "208-863-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N BENJAMIN LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049623",
            "telephone_number": "208-322-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "ELISABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Anthony Peck, LPC
• Robert T Peck, DMD
• Theresa Michele Pecsek, PMHNP-BC
• Rachael L Pedersen, NP
• Ryan Pedersen, L.AC., D.O.M.
• Pediatric Cardiology of Idaho
• Pediatric Dentistry Associates
• Pediatric Neurosurgry of Idaho PC
• Pediatric Surgery of Idaho
• Ariane Diola Pedida

• Peer Specialist in Boise, ID
• Providers in Boise, ID by specialty
• Peer Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.