Alyse Culpepper, MA

Individual provider Active NPI Marriage & Family Therapist · Meridian, ID

NPI 1982314902 · NPPES record last updated Nov 30, 2022

Key facts

NPI
1982314902
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
9187 (ID)
Practice address
1025 E Radiant Ridge Dr
Meridian, ID 83642-4013
Phone
(208) 994-4620
NPI assigned
Nov 30, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
133747CAMDMarriage & Family Therapist
9187IDMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 133747 CA
Marriage & Family Therapist 106H00000X 9187 ID Yes

Addresses

Primary practice location

1025 E Radiant Ridge Dr
Meridian, ID 83642-4013

Mailing address

1025 E Radiant Ridge Dr
Meridian, ID 83642-4013

Other providers in Meridian, ID

All providers in Meridian, ID · Marriage & Family Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.