Dr. Kracke and Associates P a

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PSY189 Issued in ID

Legal business name

DR. KRACKE AND ASSOCIATES P A

Practice address

422 17TH St
Lewiston, ID 83501-2526

Phone

(208) 743-4680

Fax

(208) 743-1756

NPI assigned

Jan 4, 2007

Last updated

Jun 30, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin R. Kracke, PH.D.NPI 1164416749

Title

President

Phone

(208) 743-4680

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Richard Kracke, PH.D.

  • Psychologist
  • Lewiston, ID
  • NPI 1164416749
  Medicare reassignment Care Compare group NPD Authorized official
• Carrie Gurgel, M.ED.

  • Mental Health Counselor
  • Lewiston, ID
  • NPI 1710970462
  Medicare reassignment Care Compare group NPD
• Teri E Rainey, M.ED., L.P.C.

  • Mental Health Counselor
  • Lewiston, ID
  • NPI 1407049497
  Medicare reassignment Care Compare group NPD
• Imelda Daley, M.S.

  • Mental Health Counselor
  • Lewiston, ID
  • NPI 1760475347
  NPD (past)
• Paul Kwon, PH.D.

  • Psychologist
  • Lewiston, ID
  • NPI 1861709990
  NPD (past)
• Delia Medlin, PH.D.

  • Psychologist
  • Lewiston, ID
  • NPI 1558354290
  NPD (past)
• Debra Street, M.S.W.

  • Social Worker
  • Lewiston, ID
  • NPI 1043203789
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1851448781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2145",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011465",
            "telephone_number": "208-743-4680",
            "fax_number": "208-743-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 17TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012526",
            "telephone_number": "208-743-4680",
            "fax_number": "208-743-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KRACKE AND ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "KRACKE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-743-4680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "PSY189",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD OF IDA",
            "identifier": "000010015963",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806177700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "N4478",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tristin King Dominguez
• David C Dortch, DMD
• Tamara Ann Coulter Dotson, PA-C
• Katelyn Doty
• Amy L Doughty, CCC-SLP
• Dr. Thomas R. Boyer, PC
• Paul Driver, PHARMD
• Keith R Drury, PT
• Elaine B Dufford, LCSW
• Kathryn M Duman, LSW

• Mental Health Counselor in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.