Active NPI
Jessica Ellen Edmunds, CRC, LPC
- Counselor
- Boise, ID
National Provider Identifier
1730953605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC-7034
- Practice address
- 7192 W Potomac Dr
Boise, ID 83704-9147 - Phone
- (208) 489-8311
- NPI assigned
- Nov 13, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-7034 | ID | |
| Rehabilitation Counselor | 225C00000X | 340617 | ID | |
| Counselor | 101Y00000X | LPC-7034 | ID | Primary |
Addresses
Primary practice location
7192 W Potomac Dr
Boise, ID 83704-9147
Mailing address
1566 S Oakland Ave
Boise, ID 83706-3447
Phone (208) 964-0202
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Jessica.Edmunds@pathways.com | Direct | Pathways of Idaho, LLC |
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-7034 | ID | MD | Counselor |
| 340617 | ID | MD | Rehabilitation Counselor |
Interoperability endpoints
- jessica.edmunds@pathways.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1730953605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1566 S OAKLAND AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837063447",
"telephone_number": "208-964-0202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7192 W POTOMAC DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837049147",
"telephone_number": "208-489-8311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMUNDS",
"first_name": "JESSICA",
"middle_name": "ELLEN",
"credential": "CRC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-13",
"last_updated": "2023-11-13",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC-7034",
"primary": false
},
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "ID",
"license": "340617",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ID",
"license": "LPC-7034",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Jessica.Edmunds@pathways.com",
"affiliation": "Y",
"endpointDescription": "Work Email",
"affiliationName": "Pathways of Idaho, LLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7192 W Potomac Dr",
"city": "Boise",
"state": "ID",
"country_code": "US",
"postal_code": "837049147",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.