Individual provider Active NPI

Carol Lowry, ACADC

  • Addiction (Substance Use Disorder) Counselor
  • Hayden, ID
National Provider Identifier
1689311045
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
13024 Issued in ID
Practice address
8382 N Wayne Dr Ste 201
Hayden, ID 83835-6028
Phone
(208) 762-8777
NPI assigned
May 17, 2022
Last updated
May 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13024 ID Primary

Addresses

Primary practice location

8382 N Wayne Dr Ste 201
Hayden, ID 83835-6028

Mailing address

8382 N Wayne Dr Ste 201
Hayden, ID 83835-6028
Phone (208) 762-8777

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

LicenseStateTypeSpecialty
13024IDMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Living Water Youth Ranch Addiction (Substance Use Disorder) CurrentSince Aug 7, 2022 Accepting new patients

Locations

8382 N Wayne Dr
Ste 201
Hayden, ID 83835
Phone (208) 714-0478

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1689311045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8382 N WAYNE DR STE 201",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838356028",
            "telephone_number": "208-762-8777",
            "fax_number": "208-762-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8382 N WAYNE DR STE 201",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838356028",
            "telephone_number": "208-762-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRY",
        "first_name": "CAROL",
        "credential": "ACADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "13024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.