Active NPI
Amanda Lauren Schroeder, MS, LPC
- Professional Counselor
- Boise, ID
National Provider Identifier
1790122364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC5215
- Practice address
- 6650 W Emerald St
Boise, ID 83704-8738 - Phone
- (904) 566-4762
- NPI assigned
- May 22, 2013
- Last updated
- May 22, 2013
- Sex
- Female
- 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 | LPC5215 | ID | Primary |
Addresses
Primary practice location
6650 W Emerald St
Boise, ID 83704-8738
Mailing address
412 W Reese St
Boise, ID 83706-6233
Phone (904) 566-4762
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC5215 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1790122364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 W REESE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837066233",
"telephone_number": "904-566-4762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6650 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837048738",
"telephone_number": "904-566-4762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "AMANDA",
"middle_name": "LAUREN",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-22",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC5215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
- James Hunter Schrader, D.O.
- Julie Schrader, NP
- Stephen John Schrader, LPCP
- Susan Marie Schram, PA-C
- Joan Kathleen Schramm, LCP
- Connie Koepke Schroeder, OTR
- Kalie Ann Schroeder
- Seth Thomas Schroeder
- Schryver Medical Sales and Marketing, LLC (Schryver Medical)
- Schryver Medical Sales and Marketing, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.