Provider Demographics
NPI:1285308502
Name:SHEARER, KRISTEN EMILY (LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:EMILY
Last Name:SHEARER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S ORCHARD ST STE 128
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-1288
Mailing Address - Country:US
Mailing Address - Phone:208-352-6018
Mailing Address - Fax:
Practice Address - Street 1:410 S ORCHARD ST STE 160
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1295
Practice Address - Country:US
Practice Address - Phone:208-352-6018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health