Individual provider Active NPI

Jessica Robichaud, LMFT, LCPC

  • Marriage & Family Therapist
  • Coeur d'Alene, ID
National Provider Identifier
1942932231
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT-10587 Issued in ID
Practice address
2101 N Lakewood Dr Ste 222
Coeur D Alene, ID 83814-2473
Phone
(208) 274-3320
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT-10587 ID Primary

Addresses

Primary practice location

2101 N Lakewood Dr Ste 222
Coeur D Alene, ID 83814-2473

Mailing address

2101 N Lakewood Dr Ste 222
Coeur D Alene, ID 83814-2473
Phone (208) 274-3320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 28, 2024 through Jun 28, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT-10587IDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Christian Counseling, LLC Marriage & Family Therapist CurrentSince Jul 3, 2022 Accepting new patients

Locations

2101 N Lakewood Dr
Ste 222
Coeur D Alene, ID 83814
Phone (208) 274-3320

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1942932231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N LAKEWOOD DR STE 222",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142473",
            "telephone_number": "208-274-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N LAKEWOOD DR STE 222",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142473",
            "telephone_number": "208-274-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBICHAUD",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "LMFT, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-10587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.