P Praxis·MD
● Active Type 1 · Individual

Jaclyn Moore, LCPC

Counselor·Boise, ID· NPI 1992186506 · Enumerated 2015 · 10 years on NPI
Moore is 1 of 551 counselor providers in Boise and 1 of 1998 in Idaho.
NPI age
10 years
Enumerated 2015-06-10
Primary specialty
Counselor
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2018-08-16
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 1998 active counselor providers in Idaho.

NPI age
10 years
↑ 3 yr above median (7 yr)
State licenses
1 state
4% of peers hold multiple states
Subspecialties
0
21% of peers hold subspecialties

NPI lifetime · 2015 → 2026

2015-06Enumerated in NPPES
2015 2026

Where they practice

Practice location
2577 S Five Mile Rd Ste 101
Boise, ID 83709
📞 2086391897fax 2086399957
Mailing address
2577 S Five Mile Rd Ste 101
Boise, ID 837092325
📞 2086391897fax 2086399957

Specialties

  • Counselor Primary
    Definition to come...
    ID license #6879 taxonomy 101YM0800X

Practice context

Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.

Recently enumerated nearby: 31 new counselor providers have been added in Boise in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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