Susan Kelli Shake
Susan Kelli Shake is a Counselor in Boise, Idaho. Registered with an NPI since 2025.
- In the registry since
- 2025
- Specialties on file
- 4
Practice location Address checks out
1655 W Fairview Ave Ste 209Boise, ID 83702-5190
Phone: (208) 352-0343
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Specialties & licences
| Marriage & Family Therapist (primary) | Taxonomy 106H00000X |
|---|---|
| Counselor | Taxonomy 101Y00000X |
| Mental Health Counselor | Taxonomy 101YM0800X |
| Professional Counselor | Taxonomy 101YP2500X |
Record details
| NPI number | 1114801974 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | August 4, 2025 |
| Last updated in NPPES | August 4, 2025 |
| Certification date | August 4, 2025 |
| Mailing address | 1655 W Fairview Ave Ste 209, Boise, ID 83702-5190 |
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