DR. KEVIN RICHARD KRACKE PH.D.
NPI 1164416749
Psychologist in Lewiston, ID

Active since September 09, 2005PECOS EnrolledAccepts Medicare Assignment
422 17TH ST, LEWISTON, ID 83501(208) 743-4680(208) 743-1756 Get Directions Write a Review

NPPES record last updated: March 15, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kevin Richard Kracke Ph.d. NPPES

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

DR. KEVIN RICHARD KRACKE PH.D. (NPI 1164416749) is an individual psychologist in Lewiston, Idaho, licensed in Idaho (PSY189) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1980).

NPPES Registry Identity

NPI1164416749
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. KEVIN RICHARD KRACKECredential: PH.D.
Location Address422 17TH STLewiston, ID 83501-2526
Mailing AddressPo Box 2145Lewiston, ID 83501-1465 · (208) 743-4680 · Fax (208) 743-1756
Fax(208) 743-1756
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateSeptember 9, 2005
Last NPPES UpdateMarch 15, 2013
NPI 1164416749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in ID · PSY189
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
422 17TH ST, Lewiston, ID 83501

Other Identifiers 4

Medicaid806177700ID
Other000010015963ID · Blueshield Of Idaho
Medicare ID-Type Unspecified1376238ID · Cigna Medicare
OtherN4478ID · Blue Cross Of Idaho

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Richard Kracke Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082519830
PECOS Enrollment IDI20040108000543
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

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

Counselor (Mental Health)
422 17TH ST
LEWISTON, ID 83501
Psychologist
422 17TH ST
LEWISTON, ID 83501
Social Worker (Clinical)
422 17TH ST
LEWISTON, ID 83501
Counselor (Mental Health)
422 17TH ST
LEWISTON, ID 83501
Counselor (Mental Health)
422 17TH ST
LEWISTON, ID 83501
Counselor (Mental Health)
422 17TH ST
LEWISTON, ID 83501
Psychologist
422 17TH ST
LEWISTON, ID 83501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Kracke's NPI number?

The NPI number for Kevin Kracke is 1164416749. It was assigned to this individual provider in the NPPES registry on September 9, 2005.

Where is Kevin Kracke located?

Kevin Kracke practices at 422 17th St, Lewiston, ID 83501. The listed phone number is (208) 743-4680.

What is Kevin Kracke's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kevin Kracke enrolled in Medicare?

Yes. Kevin Kracke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kevin Kracke accept?

Health plans from Providence Health Plan and Select Health list Kevin Kracke as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Kracke was last updated on March 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.