Kerry Elder

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

410 S Orchard St Ste 128
Boise, ID 83705-1288

Phone

(208) 850-3542

NPI assigned

Dec 14, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pines Counseling and Play Center

  • Professional Counselor
  • Boise, ID
  • NPI 1134966039
  NPD Authorized official

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1982290938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12514 W MACUMBO ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095169",
            "telephone_number": "208-850-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S ORCHARD ST STE 128",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051288",
            "telephone_number": "208-850-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "KERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Elbermawy, MD
• Jacquie Anne Elcox, BC- HIS
• Khaled Eldemerdash, RPH
• Becky M. Elder, NP
• Douglas Scott Elder, CRNA
• Anita Elderkin, LCPC
• Melissa Eldredge, LMSW
• Steffanie Eldredge
• Summer Eldredge
• Eleanor Health Professional TX, PLLC

• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.