Active NPI
Shannon L Traver, LCPC
- Professional Counselor
- Boise, ID
National Provider Identifier
1922284900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC3935
- Practice address
- 750 Warm Springs Ave Ste D
Boise, ID 83712-6457 - Phone
- (208) 871-7693
- NPI assigned
- Jan 21, 2008
- Sex
- Female
- 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 | LCPC3935 | ID | Primary |
Addresses
Primary practice location
750 Warm Springs Ave Ste D
Boise, ID 83712-6457
Mailing address
750 Warm Springs Ave Ste D
Boise, ID 83712-6457
Phone (208) 871-7693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 12, 2024 through Apr 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC3935 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294358400000",
"number": "1922284900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 WARM SPRINGS AVE STE D",
"city": "BOISE",
"state": "ID",
"postal_code": "837126457",
"telephone_number": "208-871-7693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 WARM SPRINGS AVE STE D",
"city": "BOISE",
"state": "ID",
"postal_code": "837126457",
"telephone_number": "208-871-7693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVER",
"first_name": "SHANNON",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-21",
"last_updated": "2011-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC3935",
"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 Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.