Individual provider Active NPI

Kathryn Bonzo, LPC

  • Mental Health Counselor
  • Moscow, ID
National Provider Identifier
1710870985
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1071470 Issued in ID
Practice address
213 N Main St Ste 1B
Moscow, ID 83843-2700
Phone
(208) 683-8320
Fax
(208) 969-8380
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1071470 ID
Mental Health Counselor 101YM0800X 1071470 ID Primary

Addresses

Primary practice location

213 N Main St Ste 1B
Moscow, ID 83843-2700

Mailing address

148 S Cole Rd
Boise, ID 83709-0932
Phone (208) 683-8320

Other practice location 1

148 S Cole Rd
Boise, ID 83709-0932
Phone (208) 683-8320

Other practice location 2

411 Main Street Unit G
Kamiah, ID 83536
Phone (208) 683-8320

Other practice location 3

509 S Middleton Rd
Middleton, ID 83644-6046
Phone (208) 683-8320

Other practice location 4

496 Shoup Ave W Ste F
Twin Falls, ID 83301-5043
Phone (208) 683-8320

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
1071470IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Jun 3, 2025 Accepting new patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Jun 1, 2025 Accepting new patients

Locations

148 S Cole Rd
Boise, ID 83709
Phone (208) 683-8320

509 S Middleton Rd
Middleton, ID 83644
Phone (208) 683-8320

213 N Main St
Ste 1B
Moscow, ID 83843
Phone (208) 683-8320

496 Shoup Ave W
Ste F
Twin Falls, ID 83301
Phone (208) 683-8320

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1710870985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 S COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090932",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N MAIN ST STE 1B",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432700",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 S Cole Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837090932",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 Main Street Unit G",
            "address_purpose": "LOCATION",
            "city": "Kamiah",
            "state": "ID",
            "postal_code": "83536",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 S Middleton Rd",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "ID",
            "postal_code": "836446046",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "496 Shoup Ave W Ste F",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833015043",
            "country_code": "US",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONZO",
        "first_name": "KATHRYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-08-04",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "1071470",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "1071470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.