BLAKE SMITH LPC
NPI 1114753225
Counselor - Professional in Boise, ID
Active since September 13, 2024
About Blake Smith Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLAKE SMITH LPC (NPI 1114753225) is an individual professional provider in Boise, Idaho, licensed in Idaho (9771552) and active in the NPI registry since September 2024.
NPPES Registry Identity
NPI1114753225
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameBLAKE SMITHCredential: LPC
Location Address9196 W EMERALD ST STE 130Boise, ID 83704-8003
Mailing Address9196 W Emerald St Ste 130Boise, ID 83704-8003 · (208) 323-4400
Phone(208) 323-4400
Sole ProprietorYes
Enumeration DateSeptember 13, 2024
Last NPPES UpdateApril 18, 20263 updates tracked since enumeration
NPPES CertifiedApril 18, 2026
✔ NPI 1114753225 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in ID · 9771552
9196 W EMERALD ST STE 130, Boise, ID 83704
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114753225, enumerated as an "individual" on September 13, 2024.
The provider is located at 9196 W EMERALD ST STE 130 BOISE, ID 83704 and the phone number is (208) 323-4400.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
