Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelsey Lynne Blazicevich, LPC

Individual provider Counselor · NPI 1174149215

Kelsey Lynne Blazicevich, LPC is a Mental Health Counselor in Caldwell, Idaho. Qualified in 2020, 6 years ago. Practices as a sole proprietor.

Years since qualifying
6
In the registry since
2020
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

923 Grant St
Caldwell, ID 83605-4137
Phone: (208) 585-3375
Fax: (208) 585-6152
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X

Record details

NPI number1174149215
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedJune 24, 2020
Last updated in NPPESJune 24, 2020
Certification dateJune 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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