Individual provider Active NPI

Corry Tomlinson Nordby, LPC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1851938237
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-7361 Issued in ID
Practice address
3663 N Lakeharbor LN
Boise, ID 83703-6913
Phone
(208) 650-7359
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-7361 ID Primary

Addresses

Primary practice location

3663 N Lakeharbor LN
Boise, ID 83703-6913

Mailing address

3663 N Lakeharbor LN
Boise, ID 83703-6913
Phone (208) 650-7359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 17, 2024 through Apr 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-7361IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cultivation, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1851938237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 N LAKEHARBOR LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837036913",
            "telephone_number": "208-650-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 N LAKEHARBOR LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837036913",
            "telephone_number": "208-650-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDBY",
        "first_name": "CORRY",
        "middle_name": "TOMLINSON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-7361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.