Active NPI
Katie Conlon Jacobs, LCPC
- Counselor
- Boise, ID
National Provider Identifier
1922245273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LCPC4643
- Practice address
- 2273 S Vista Ave
Suite 190
Boise, ID 83705-7341 - Phone
- (208) 343-2737
- NPI assigned
- Jan 8, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LCPC4643 | ID | Primary |
Addresses
Primary practice location
2273 S Vista Ave
Suite 190
Boise, ID 83705-7341
Mailing address
2273 S Vista Ave
Suite 190
Boise, ID 83705-7341
Phone (208) 343-2737
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 |
|---|---|---|---|
| LCPC4643 | ID | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304553600000",
"number": "1922245273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2273 S VISTA AVE",
"address_2": "SUITE 190",
"city": "BOISE",
"state": "ID",
"postal_code": "837057341",
"telephone_number": "208-343-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2273 S VISTA AVE",
"address_2": "SUITE 190",
"city": "BOISE",
"state": "ID",
"postal_code": "837057341",
"telephone_number": "208-343-2737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "KATIE",
"middle_name": "CONLON",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-08",
"last_updated": "2011-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ID",
"license": "LCPC4643",
"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 May 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.