NPIMap

Organization Active NPI

Calm Waters Counseling PLLC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1972141265
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CALM WATERS COUNSELING PLLC
Practice address
10108 W Overland Rd # a
Boise, ID 83709-1428
Phone
(208) 371-7226
Fax
(208) 375-7251
NPI assigned
Dec 17, 2019
Last updated
Dec 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Authorized official

Name
Mr. David Allen Martin, MA, LPC, EMDR-T, RSNPI 1518340298
Title
Clinical Director/Owner
Phone
(208) 371-7226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

10108 W Overland Rd # a
Boise, ID 83709-1428

Mailing address

10108 W Overland Rd # a
Boise, ID 83709-1428
Phone (208) 371-7226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240502002530 ID Part B Supplier - Clinic/Group Practice 7719327139 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

National Provider Directory

National Provider Directory
Tax ID family
Calm Waters Counseling PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10108 W Overland Rd
#A
Boise, ID 83709
Phone (208) 376-1532

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1972141265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10108 W OVERLAND RD # A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-371-7226",
            "fax_number": "208-375-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10108 W OVERLAND RD # A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-371-7226",
            "fax_number": "208-375-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM WATERS COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "208-371-7226",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LPC, EMDR-T, RS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "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 Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.