SUSAN KELLI SHAKE
NPI 1114801974
Marriage & Family Therapist in Boise, ID

Q: What is Susan Shake's NPI number?

The NPI number for Susan Shake is 1114801974. It was assigned to this individual provider in the NPPES registry on August 4, 2025.

Q: What is Susan Shake's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Shake was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 04, 2025

1655 W FAIRVIEW AVE STE 209, BOISE, ID 83702(208) 352-0343 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Susan Kelli Shake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN KELLI SHAKE (NPI 1114801974) is an individual marriage & family therapist in Boise, Idaho and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1114801974

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameSUSAN KELLI SHAKE

Location Address1655 W FAIRVIEW AVE STE 209Boise, ID 83702-5190

Mailing Address1655 W Fairview Ave Ste 209Boise, ID 83702-5190 · (208) 352-0343

Phone(208) 352-0343

Sole ProprietorNo

Enumeration DateAugust 4, 2025

NPPES CertifiedAugust 4, 2025

✔ NPI 1114801974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedCounselorTaxonomy 101Y00000X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

1655 W FAIRVIEW AVE STE 209, Boise, ID 83702

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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH STRAUSS

Counselor