Individual provider Active NPI

Gina Marie Barragan, LPC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1912450669
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-6200 Issued in ID
Practice address
1276 W River St Ste 100
Boise, ID 83702-7083
Phone
(208) 338-4699
Fax
(208) 322-4722
NPI assigned
Jul 29, 2016
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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-6200 ID Primary

Addresses

Primary practice location

1276 W River St Ste 100
Boise, ID 83702-7083

Mailing address

613 N Stanley St
Boise, ID 83706-2029
Phone (208) 409-7499

Other practice location 1

8100 W Emerald St Ste 150
Boise, ID 83704-9057
Phone (208) 375-0752

Other names 1

  • Gina Marie Watt Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122003941 ID Practitioner - Mental Health Counselor 3678925989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1276 W River St
Suite 100
Boise, ID 83702-7083
Phone (208) 338-4699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-6200IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Behavioral Health Services Current Accepting new patients
Access Behavioral Health Services, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1276 W River St
Ste 100
Boise, ID 83702
Phone (208) 338-4699

3307 Caldwell Blvd
Ste 104
Nampa, ID 83651
Phone (208) 465-4833

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1912450669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 N STANLEY ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062029",
            "telephone_number": "208-409-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 W RIVER ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027083",
            "telephone_number": "208-338-4699",
            "fax_number": "208-322-4722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 W Emerald St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049057",
            "country_code": "US",
            "telephone_number": "208-375-0752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRAGAN",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-6200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "WATT",
            "middle_name": "MARIE",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.