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

Mrs. Polly Peterson, LPC

Individual provider Counselor · NPI 1588232904

Mrs. Polly Peterson, LPC is a Mental Health Counselor in Boise, Idaho. Qualified in 2015, 11 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
11
Licensed in
ID
In the registry since
2021
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

4948 W Kootenai St Ste 201
Boise, ID 83705-2082
Phone: (208) 810-0523
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence LPC-7723 (ID)

Record details

NPI number1588232904
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedJune 13, 2021
Last updated in NPPESAugust 7, 2023
Certification dateAugust 7, 2023

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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