Active NPI
Sarah Coleen Mallard, N.C.C., L.P.C.
- Counselor
- Nampa, ID
National Provider Identifier
1699108647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC-5300
- Practice address
- 112 12TH Ave Rd
Nampa, ID 83686-5011 - Phone
- (208) 465-5433
- Fax
- (208) 466-5802
- NPI assigned
- Aug 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC-5300 | ID | Primary |
Addresses
Primary practice location
112 12TH Ave Rd
Nampa, ID 83686-5011
Mailing address
112 12TH Ave Rd
Nampa, ID 83686-5011
Phone (208) 465-5433
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 |
|---|---|---|---|
| LPC-5300 | ID | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1699108647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 12TH AVE RD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836865011",
"telephone_number": "208-465-5433",
"fax_number": "208-466-5802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 12TH AVE RD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836865011",
"telephone_number": "208-465-5433",
"fax_number": "208-466-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLARD",
"first_name": "SARAH",
"middle_name": "COLEEN",
"credential": "N.C.C., L.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-13",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ID",
"license": "LPC-5300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.