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NPI Code Detail

MEDICARE: DAVID ROUTT LCPC, NCC

MEDICARE: DAVID ROUTT LCPC, NCC
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
1101YP2500XProfessional CounselorC9964OR
2101YP2500XProfessional CounselorLCPC-8037ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174973374
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ROUTT LCPC, NCC
Provider Business Mailing Address
First Line : 211 E LOGAN ST STE 201
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4883
Country : US
Telephone Number : 208-454-1480
Fax Number : 208-268-8444
Provider Business Practice Location Address
First Line : 211 E LOGAN ST STE 201
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4883
Country : US
Telephone Number : 208-454-1480
Fax Number : 208-268-8444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2016
Last Update Date : 11/07/2025

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Directions to “ DAVID ROUTT LCPC, NCC” Practice Location

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