Individual provider · Type 1 NPI

Susan Kelli Shake

Marriage & Family Therapist · Boise, ID

NPI number 1114801974 Active

Practice location

1655 W Fairview Ave Ste 209
Boise, ID 83702-5190

Call (208) 352-0343 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Mental Health Counselor 101YM0800XNone listed
Professional Counselor 101YP2500XNone listed
Marriage & Family Therapist Primary 106H00000XNone listed

Marriage & Family Therapist: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats ment…

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About NPI 1114801974

Susan Kelli Shake's National Provider Identifier is 1114801974, issued on Aug 4, 2025. The primary taxonomy on file is Marriage & Family Therapist (106H00000X), and the practice location is in Boise, ID. The record was last updated on Aug 4, 2025.