Individual provider Active NPI

Takoma Lindsay, PHD

  • Marriage & Family Therapist
  • Idaho Falls, ID
National Provider Identifier
1922862507
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2871447 Issued in ID
Practice address
3940 Washington Pkwy
Idaho Falls, ID 83404-7596
Phone
(208) 252-5545
NPI assigned
Feb 13, 2024
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12439475-3904 UT
Marriage & Family Therapist 106H00000X 2871447 ID Primary

Addresses

Primary practice location

3940 Washington Pkwy
Idaho Falls, ID 83404-7596

Mailing address

2666 Lavender Dr
Idaho Falls, ID 83401-6256
Phone (208) 252-5545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 25, 2025 through Mar 25, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2871447IDMDMarriage & Family Therapist
12439475-3904UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Takoma Lindsay Counseling, LLC CurrentSince Jun 8, 2025 Accepting new patients

Locations

3940 Washington Pkwy
Idaho Falls, ID 83404
Phone (208) 252-5545

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, 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": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1922862507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2666 LAVENDER DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016256",
            "telephone_number": "208-252-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047596",
            "telephone_number": "208-252-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "TAKOMA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "12439475-3904",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "2871447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.