Active NPI
Garrett Lee Coburn, LCPC
- Professional Counselor
- Kuna, ID
National Provider Identifier
1750528956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC 3851
- Practice address
- 13500 S. Pleasant Valley Rd
Kuna, ID 83634 - Phone
- (208) 336-0740
- NPI assigned
- Jan 11, 2009
- Last updated
- Nov 20, 2009
- 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 | LCPC 3851 | ID | Primary |
Addresses
Primary practice location
13500 S. Pleasant Valley Rd
Kuna, ID 83634
Mailing address
PO Box 14
Kuna, ID 83634-0014
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 |
|---|---|---|---|
| LCPC 3851 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kim Keys, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258675200000",
"number": "1750528956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14",
"city": "KUNA",
"state": "ID",
"postal_code": "836340014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13500 S. PLEASANT VALLEY RD",
"city": "KUNA",
"state": "ID",
"postal_code": "83634",
"telephone_number": "208-336-0740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBURN",
"first_name": "GARRETT",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-11",
"last_updated": "2009-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC 3851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.