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Individual provider Active NPI

Kellie Humpherys, LCSW

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1629235353
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW-37609 Issued in ID
Practice address
6933 W Emerald St
Boise, ID 83704-8616
Phone
(208) 321-0634
Fax
(208) 321-1082
NPI assigned
May 20, 2008
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW-37609 ID Primary

Addresses

Primary practice location

6933 W Emerald St
Boise, ID 83704-8616

Mailing address

6933 W Emerald St
Boise, ID 83704-8616
Phone (208) 321-0634

Other identifiers 1

IdentifierTypeStateIssuer
002803300MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000725 ID Practitioner - Clinical Social Worker 7315074929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-37609IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ricardo Ramirezs Counseling PLLC Clinical CurrentSince Jun 27, 2023 Accepting new patients
All Horizons, Inc. Mental Health CurrentSince Feb 21, 2010 Accepting new patients
All Horizons Inc Mental Health CurrentSince Feb 21, 2010 Accepting new patients
All Horizons, Inc Past Accepting new patients
All Horizons Inc Past Accepting new patients
All Horizons, Inc Past Accepting new patients
All Seasons Mental Health Past Accepting new patients
All Seasons Mental Health Past Accepting new patients
Family Care Clinic Past Accepting new patients
All Horizons, Inc Past Accepting new patients
All Horizons, Inc Past Accepting new patients
All Seasons Mental Health Past Accepting new patients
All Horizons, Inc. Past Accepting new patients

Locations

6933 W Emerald St
Boise, ID 83704
Phone (208) 321-0634

6933 W Emerald St
Ste A
Boise, ID 83704

8050 W Rifleman St
Ste 100
Boise, ID 83704
Phone (208) 321-0634

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1629235353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6933 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048616",
            "telephone_number": "208-321-0634",
            "fax_number": "208-321-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6933 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048616",
            "telephone_number": "208-321-0634",
            "fax_number": "208-321-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHERYS",
        "first_name": "KELLIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-37609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002803300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.