Deanna M Fofanoff, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC-9195 Issued in ID

Practice address

1620 Northwest Blvd Ste 201
Coeur D Alene, ID 83814-2488

Phone

(208) 651-2952

NPI assigned

Mar 30, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kindred Mental Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Coeur d'Alene, ID
  • NPI 1629944566
  NPD Authorized official
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  NPD
• Multicare Health System

  dba MultiCare Rockwood Clinic

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1730687161
  NPD
• Dirne Health Centers, Inc.

  dba Heritage Health CFHL CDA

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1194397240

  Mental Health

  NPD (past)
• Dirne Health Centers, Inc.

  dba Heritage Family Support Services of North Idaho

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1255756730

  Mental Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1154646412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 NORTHWEST BLVD STE 201",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142488",
            "telephone_number": "208-651-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 NORTHWEST BLVD STE 201",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142488",
            "telephone_number": "208-651-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOFANOFF",
        "first_name": "DEANNA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "LH60142565",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-9195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Andrew Flygare, P.A.-C.
• Patrick W Flynn, CRNA
• Tia A Flynn, AUD
• FMG Ironwood Place Idaho LLC
• FMG West Lacrosse Avenue Idaho LLC
• Shana D Fogarty, M.D.
• Miranda Caroline Foley-Kekauoha, DOULA
• Gretchen Foley, PA-C
• Martina Folowell Nix
• Paul S Fontana, ARNP

• Professional Counselor in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.