Katie J Dodge

Primary specialty

School CounselorTaxonomy code 101YS0200X

License

COUL-9249 Issued in ID

Practice address

242 E 7TH N Ste 4
Rexburg, ID 83440-3550

Phone

(208) 359-9683

NPI assigned

Jan 5, 2023

Last updated

Jan 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1750095600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 N 2650 E",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834455509",
            "telephone_number": "208-520-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 E 7TH N STE 4",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403550",
            "telephone_number": "208-359-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "KATIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "COUL-9249",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "ID",
            "license": "COUL-9249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Peak Idaho
• Sarah E. Dickey, LMSW
• Dane J Dickson, MD
• Trevor Brice Dimond, DPT
• Angelina Thao Nguyen DO
• Laura Dolezal, CCC/SLP
• Douglas J. Smith (Dental Health Center)
• Douglas R. Schultz
• Kerry Anne Draney, LCSW
• Jacob Dresen, LPC

• School Counselor in Rexburg, ID
• Providers in Rexburg, ID by specialty
• School Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.