Individual
KIP SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CM; CPSS; CBRS
Contact information
Practice address
3288 E PINE AVE, MERIDIAN, ID 83642-5922
(208) 888-8887
Mailing address
3288 E PINE AVE, MERIDIAN, ID 83642-5922
(208) 888-8887
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
ID
175T00000X
Peer Specialist
—
ID
225400000X
Rehabilitation Practitioner
—
ID
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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