Active NPI
Krista Gordon
- Mental Health Counselor
- Post Falls, ID
National Provider Identifier
1023740248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-8926
- Practice address
- 570 S Clearwater Loop Ste B
Post Falls, ID 83854-5437 - Phone
- (208) 777-2169
- Fax
- (208) 777-2189
- NPI assigned
- Jun 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-8926 | ID | Primary |
Addresses
Primary practice location
570 S Clearwater Loop Ste B
Post Falls, ID 83854-5437
Mailing address
570 S Clearwater Loop Ste B
Post Falls, ID 83854-5437
Phone (208) 777-2169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 11, 2024 through Apr 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-8926 | ID | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bigfoot Counseling, LLC | Mental Health | Current | Accepting new patients |
| Cultivation, LLC | Past | Accepting new patients |
Locations
570 S Clearwater Loop
Ste B
Post Falls, ID 83854
Phone (208) 777-2169
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Coeur D'Alene, ID
- NPI 1124466990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1023740248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 S CLEARWATER LOOP STE B",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838545437",
"telephone_number": "208-777-2169",
"fax_number": "208-777-2189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 S CLEARWATER LOOP STE B",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838545437",
"telephone_number": "208-777-2169",
"fax_number": "208-777-2189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "KRISTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC-8926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Post Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.