Melinda Carpenter, LCPC
Individual provider Active NPI Mental Health Counselor · Mountain Home, ID
NPI 1013469808 · NPPES record last updated Oct 24, 2024
Key facts
- NPI
- 1013469808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LCPC-7557 (ID)
- Practice address
- 120 Desert Sage Way
Mountain Home, ID 83647-1038 - Phone
- (208) 587-3988
- Fax
- (208) 587-3324
- NPI assigned
- Oct 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Glenns Ferry Health Center Inc
Practice addresses (Care Compare)
120 Desert Sage Way
Mountain Home, ID 83647-1038
Phone (208) 587-3988
486 W 1St Ave
Glenns Ferry, ID 83623-2701
Phone (208) 366-7416
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240506004807 | ID | Practitioner - Mental Health Counselor | 0042650103 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glenns Ferry Health Center, Inc. | Current |
Accepting new patients | |
| Glenns Ferry Health Center, Inc. | Current |
Accepting new patients | |
| Glenns Ferry Health Center, Inc. | Past | Accepting new patients |
Locations
486 W 1st Ave
Glenns Ferry, ID 83623
Phone (208) 366-7416
560 E Jackson St
Mountain Home, ID 83647
Phone (208) 587-3988
120 Desert Sage Way
Mt Home, ID 83647
Phone (208) 587-3988
Interoperability endpoints
- melinda.carpenter.1@16522.direct.athenahealth.com
- https://api.platform.athenahealth.com/16522/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCPC-7557 | ID | Yes |
Addresses
Primary practice location
120 Desert Sage Way
Mountain Home, ID 83647-1038
Mailing address
120 Desert Sage Way
Mountain Home, ID 83647-1038
Phone (208) 587-3398
Other providers in Mountain Home, ID
- Tracy Lynn Bideganeta
- Boise Vamc
- Shelby Bonello
- Josephine S Brown
- Anson C Call
- Lee James Carter
- Belinda Ann Childers
- Alana Christian
- Jessica Christian
- Charlene Clark
All providers in Mountain Home, ID · Mental Health Counselor in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.