Savanah Shae Packard, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-8623 Issued in ID

Practice address

425 Mindy Dr
Chubbuck, ID 83202-2263

Phone

(208) 339-0368

NPI assigned

Jan 11, 2022

Last updated

Jan 11, 2022By the provider in NPPES

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

Enrolled in ID

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Stillwaters Counseling LLC

  • Mental Health Counselor
  • Blackfoot, ID
  • NPI 1275638645
  Medicare reassignment NPD

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1730830811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 CAMAS ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832213060",
            "telephone_number": "208-782-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MINDY DR",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022263",
            "telephone_number": "208-339-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "SAVANAH",
        "middle_name": "SHAE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-8623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laila Ann Oakes, SLP
• Ashlynn Hayden Oborn, LMSW
• Shea Orr, PARAPROFESSIONAL
• Ashley Otis
• Holly Noelle Pace, OTR/L
• Timothy Lee Page, D.C.
• Mason Palmer
• Alan David Pannier, PHARMACY INTERN
• Kelly Petersen, RD
• Wiley D Petersen, PA-C

• Mental Health Counselor in Chubbuck, ID
• Providers in Chubbuck, 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 Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.