Active NPI
Keri Gloria Lee
- Counselor
- Rathdrum, ID
National Provider Identifier
1609133495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LCPC 2913
- Practice address
- 1803 W Garwood Rd
Rathdrum, ID 83858-7108 - Phone
- (208) 209-2309
- NPI assigned
- Apr 18, 2012
- Last updated
- Apr 18, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LCPC 2913 | ID | Primary |
| Mental Health Counselor | 101YM0800X | LCPC 2913 | ID | |
| Marriage & Family Therapist | 106H00000X | LCPC 2913 | ID |
Addresses
Primary practice location
1803 W Garwood Rd
Rathdrum, ID 83858-7108
Mailing address
1803 W Garwood Rd
Rathdrum, ID 83858-7108
Phone (208) 209-2309
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 |
|---|---|---|---|
| LCPC 2913 | ID | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334707200000",
"number": "1609133495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 W GARWOOD RD",
"city": "RATHDRUM",
"state": "ID",
"postal_code": "838587108",
"telephone_number": "208-209-2309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 W GARWOOD RD",
"city": "RATHDRUM",
"state": "ID",
"postal_code": "838587108",
"telephone_number": "208-209-2309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KERI",
"middle_name": "GLORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-18",
"last_updated": "2012-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ID",
"license": "LCPC 2913",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCPC 2913",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "ID",
"license": "LCPC 2913",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rathdrum, ID
- Lakeland Family Dental
- Lakeland Family Dental LLC
- Lakeland Immediate Care LLC
- Lakeland Joint School Disrict #272
- Lakeland Physical Therapy and Sports Injuries P a (North Idaho Physical Therapy)
- Lighthouse Counseling LLC
- Lorene H Lindley MD PC
- Elizabeth Anne Mallinen
- Luke T Mallory, DPT
- MBS Therapy Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.