Active NPI
Lindsay Rae Kenley, NCC, LPC
- Mental Health Counselor
- Eagle, ID
National Provider Identifier
1831643154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCPC-7112
- Practice address
- 533 E Riverside Dr Ste 120
Eagle, ID 83616-6585 - Phone
- (208) 298-9886
- NPI assigned
- Aug 4, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-6220 | ID | |
| Mental Health Counselor | 101YM0800X | LCPC-7112 | ID | Primary |
Addresses
Primary practice location
533 E Riverside Dr Ste 120
Eagle, ID 83616-6585
Mailing address
2491 N Devlin Ave
Meridian, ID 83646-5091
Phone (208) 298-9886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 15, 2024 through Jan 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC-7112 | ID | MD | Mental Health Counselor |
| LPC-6220 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1831643154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2491 N DEVLIN AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836465091",
"telephone_number": "208-298-9886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "533 E RIVERSIDE DR STE 120",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166585",
"telephone_number": "208-298-9886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENLEY",
"first_name": "LINDSAY",
"middle_name": "RAE",
"name_prefix": "Miss",
"credential": "NCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-04",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC-6220",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCPC-7112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.