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1386437457 NPI number — PATTI JOLEEN SUMMERS LPC

NPI Number: 1386437457
Health Care Provider/Practitioner: PATTI JOLEEN SUMMERS LPC

Information about “1386437457” NPI (PATTI JOLEEN SUMMERS LPC) exists in 1386437457 in HTML format HTML  |  1386437457 in plain Text format TXT  |  1386437457 in PDF (Portable Document Format) PDF  |  1386437457 in an XML format XML  formats.

NPI Number : 1386437457 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386437457",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SUMMERS",
    "FirstName": "PATTI",
    "MiddleName": "JOLEEN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "125 COLLEGE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "IDAHO FALLS",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83402-2235",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-339-4356",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "490 PARK AVE STE 4",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "IDAHO FALLS",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83402-1230",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-339-4356",
    "PracticeLocationAddressFaxNumber": "208-612-5035",
    "EnumerationDate": "05/22/2025",
    "LastUpdateDate": "06/05/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "COUI-10191",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "COUI-10191",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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