MEDICARE: DR. PAT AKSAMIT PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LCPC68	ID
2	103T00000X	Psychologist	PSY372	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BC Q8682	OTHER	ID	BLUE CROSS PROVIDER
2	000010017682	OTHER	ID	BLUE SHEILD PROVIDER

General Provider Information

NPI Number	:	1235276460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAT AKSAMIT PHD

Provider Business Mailing Address
First Line	:	3350 AMERICANA TER
Second Line	:	SUITE300
City	:	BOISE
State	:	ID
Zip	:	83706-2521
Country	:	US
Telephone Number	:	208-343-1113
Fax Number	:	208-343-0040

Provider Business Practice Location Address
First Line	:	3350 AMERICANA TER
Second Line	:	SUITE300
City	:	BOISE
State	:	ID
Zip	:	83706-2521
Country	:	US
Telephone Number	:	208-343-1113
Fax Number	:	208-343-0040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	09/11/2025

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Directions to “ DR. PAT AKSAMIT PHD” Practice Location

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