Individual provider Active NPI

Linwood Glenn Vereen

  • Professional Counselor
  • Boise, ID
National Provider Identifier
1902574338
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-3305 Issued in ID
Practice address
3852 N Eagle Rd
Boise, ID 83713-0750
Phone
(208) 378-0014
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-3305 ID Primary

Addresses

Primary practice location

3852 N Eagle Rd
Boise, ID 83713-0750

Mailing address

609 W King St
Shippensburg, PA 17257-1617
Phone (208) 760-7711

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

LicenseStateTypeSpecialty
LPC-3305IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center at Tree City, Inc. CurrentSince Sep 5, 2021 Accepting new patients

Locations

3852 N Eagle Rd
Boise, ID 83713
Phone (208) 376-7997

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1902574338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W KING ST",
            "city": "SHIPPENSBURG",
            "state": "PA",
            "postal_code": "172571617",
            "telephone_number": "208-760-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3852 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130750",
            "telephone_number": "208-378-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEREEN",
        "first_name": "LINWOOD",
        "middle_name": "GLENN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-3305",
            "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 Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.