Individual provider Active NPI

Christina M Smith, LCSW

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1982907358
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW24969 Issued in ID
Practice address
6550 W Emerald St
Ste 108
Boise, ID 83704-8780
Phone
(208) 342-6300
NPI assigned
Dec 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW24969 ID Primary

Addresses

Primary practice location

6550 W Emerald St
Ste 108
Boise, ID 83704-8780

Mailing address

6550 W Emerald St
Ste 108
Boise, ID 83704-8780
Phone (208) 342-6300

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW24969IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291680000000",
    "number": "1982907358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 W EMERALD ST",
            "address_2": "STE 108",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048780",
            "telephone_number": "208-342-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 W EMERALD ST",
            "address_2": "STE 108",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048780",
            "telephone_number": "208-342-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-07",
        "last_updated": "2010-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW24969",
            "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 7, 2010; 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.