Active NPI
Randall Dean Meenach, M.A.
- Professional Counselor
- Boise, ID
National Provider Identifier
1740465624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-3608
- Practice address
- 1517 W Jefferson St
Boise, ID 83702-5218 - Phone
- (208) 385-0888
- Fax
- (208) 385-0024
- NPI assigned
- Jan 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-3608 | ID | Primary |
Addresses
Primary practice location
1517 W Jefferson St
Boise, ID 83702-5218
Mailing address
7329 Swift LN
Boise, ID 83704-5963
Phone (208) 794-3053
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-3608 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199836800000",
"number": "1740465624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7329 SWIFT LN",
"city": "BOISE",
"state": "ID",
"postal_code": "837045963",
"telephone_number": "208-794-3053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1517 W JEFFERSON ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837025218",
"telephone_number": "208-385-0888",
"fax_number": "208-385-0024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEENACH",
"first_name": "RANDALL",
"middle_name": "DEAN",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-09",
"last_updated": "2008-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-3608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.