Individual provider Active NPI

Issa Ntakarutimana, LCSW

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1821681982
Registry record updated May 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
500 W Bannock St
Boise, ID 83702-5916
Phone
(208) 598-8442
NPI assigned
Feb 18, 2021
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 W Bannock St
Boise, ID 83702-5916
Phone (208) 329-8658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20241218002613 ID Practitioner - Clinical Social Worker 8022545854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Commonplace Wellness LLC Mental Health CurrentSince Sep 23, 2024 Accepting new patients

Locations

500 W Bannock St
Boise, ID 83702
Phone (208) 284-1011

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Mental Health Counselor 101YM0800X ID Primary

Addresses

NPPES NPI Registry

Primary practice location

500 W Bannock St
Boise, ID 83702-5916

Mailing address

205 S Bruce LN
Boise, ID 83712-7804
Phone (208) 906-5878

Other names 1

NPPES NPI Registry
  • Ntakautimana Issa Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 18, 2025.

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747526400000",
    "number": "1821681982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S BRUCE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837127804",
            "telephone_number": "208-906-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025916",
            "telephone_number": "208-598-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTAKARUTIMANA",
        "first_name": "ISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-18",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NTAKAUTIMANA",
            "last_name": "ISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.