Kathleen A Weathers, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-8484 Issued in ID

Practice address

1550 S Cloverdale Rd Ste 201
Boise, ID 83709-1128

Phone

(208) 577-1262

Fax

(208) 247-0585

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1649821919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S CLOVERDALE RD STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091128",
            "telephone_number": "208-577-1262",
            "fax_number": "208-247-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S CLOVERDALE RD STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091128",
            "telephone_number": "208-577-1262",
            "fax_number": "208-247-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-8484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Mortensen DMD PC (Smiles on State Street)
• Wayne R. Peterson, DMD, PC
• Danielle Wayne, LCSW, LISW
• Coire Weathers, MD
• Emmy Laurie Weathers, MSW, LMSW
• Matthew Caleb Weaver
• Metta Katherine Lee Weaver, APRN, CNM
• Rachel N Weaver, LMT
• Sheila Weaver, LMSW
• Alexandria Webb, MD

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.