Justin Jacobs Hacking, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-5125 Issued in ID

Practice address

1011 W Williams St
Suite G
Boise, ID 83706-3564

Phone

(208) 991-0077

Fax

(208) 922-3778

NPI assigned

Feb 16, 2013

Last updated

Apr 16, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  OR

  Medicare reassignment Care Compare group NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - EOMA

  • Rural Health Clinic/Center
  • Baker City, OR
  • NPI 1336442607
  NPD
• Real Solutions Counseling, LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1588986376
  NPD (past)

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1932449667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W WILLIAMS ST",
            "address_2": "SUITE G",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063564",
            "telephone_number": "208-991-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W WILLIAMS ST",
            "address_2": "SUITE G",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063564",
            "telephone_number": "208-991-0077",
            "fax_number": "208-922-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKING",
        "first_name": "JUSTIN",
        "middle_name": "JACOBS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-5125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Paul Haase, LCPC
• Murtuza H Habeeb, MD
• Mariam Habib
• Stacy Marie Hackenmiller, FNP
• Kelsy Reid Hacker, PA-C
• Carol Covington Hackney, L.C.P.C.
• Jennifer Ann Hackwith, NP
• Laurie Hadden, LICENSED MIDWIFE
• Dalon Hadfield, RN
• Stephanie Hadley, LCSW

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.