Provider Demographics
NPI:1760799605
Name:ABERCROMBIE, KASEY MARIE (MA LCPC)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:MARIE
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 N HIGHBROOK WAY
Mailing Address - Street 2:SUITE 106 PMB 389
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669
Mailing Address - Country:US
Mailing Address - Phone:208-614-2949
Mailing Address - Fax:
Practice Address - Street 1:1720 N WESTGATE DR STE 1A
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7164
Practice Address - Country:US
Practice Address - Phone:208-614-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-6410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health