KELLIE HUMPHERYS NPI 1629235353

NPI Information

  • NPI: 1629235353
  • Provider Name: KELLIE HUMPHERYS
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8050 W RIFLEMAN ST # 100
    BOISE, ID
    ZIP 83704
  • Phone: (208) 321-0634

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NPI Details

Kellie Humpherys is a mental health counselor in Boise, ID. Kellie Humpherys NPI is 1629235353. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8050 W RIFLEMAN ST # 100
BOISE, ID
ZIP 83704-000
Phone: (208) 321-0634
Fax: (208) 321-1082

The NPI 1629235353 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/20/2008 and was last updated on 4/29/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthLMSW1095IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1002803300MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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