=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598814477
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KEVIN PAUL RHINEHART MSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3631 OVERLAND CHRISTIAN COUNSELING CENTER
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-343-0441
-----------------------------------------------------
Fax | 208-343-4993
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3631 OVERLAND CHRISTIAN COUNSELING CENTER
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-343-0441
-----------------------------------------------------
Fax | 208-343-4993
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCSW612
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LMFT2705
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------