Active NPI
Charles Diemart, LPC
- Professional Counselor
- Boise, ID
National Provider Identifier
1861877417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC - 5908
- Practice address
- 2577 S Five Mile Rd
Boise, ID 83709-2325 - Phone
- (208) 918-1635
- Fax
- (208) 917-8600
- NPI assigned
- Jul 24, 2015
- Sex
- Male
- 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 | LPC - 5908 | ID | Primary |
Addresses
Primary practice location
2577 S Five Mile Rd
Boise, ID 83709-2325
Mailing address
508 W Garfield St
Boise, ID 83706-4348
Phone (208) 918-1635
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC - 5908 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454630400000",
"number": "1861877417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 W GARFIELD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837064348",
"telephone_number": "208-918-1635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2577 S FIVE MILE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837092325",
"telephone_number": "208-918-1635",
"fax_number": "208-917-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEMART",
"first_name": "CHARLES",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-24",
"last_updated": "2016-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC - 5908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.