Active NPI
Jorge Domingo Reyes, MS
- Professional Counselor
- Nampa, ID
National Provider Identifier
1578965422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-5723
- Practice address
- 5700 E. Franklin Rd.
Suite 220-I
Nampa, ID 83687 - Phone
- (208) 514-9497
- NPI assigned
- Sep 23, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-5723 | ID | Primary |
| Mental Health Counselor | 101YM0800X | LPC-5723 | ID |
Addresses
Primary practice location
5700 E. Franklin Rd.
Suite 220-I
Nampa, ID 83687
Mailing address
995 N. World Cup LN
Eagle, ID 83616
Phone (208) 514-9497
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-5723 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459468800000",
"number": "1578965422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 N. WORLD CUP LN",
"city": "EAGLE",
"state": "ID",
"postal_code": "83616",
"telephone_number": "208-514-9497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5700 E. FRANKLIN RD.",
"address_2": "SUITE 220-I",
"city": "NAMPA",
"state": "ID",
"postal_code": "83687",
"telephone_number": "208-514-9497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "JORGE",
"middle_name": "DOMINGO",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-23",
"last_updated": "2016-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-5723",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC-5723",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
- Rescare Washington Inc
- Resilient Connections Counseling PLLC
- Resilient Mental Health LLC
- Resilient Transport LLC
- Revitalize Consulting Group, Inc. (Revitalize Counseling Center)
- John Reyna, LCPC
- Kathryn C Reynolds, PHARMD
- Willow Bryn Reynolds, LMSW
- Rhythm & Grace Counseling
- Ricardo Ramirezs Counseling PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.