Ivan Atole III, LPC/LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0017086 Issued in CO

Practice address

302 W Ponderosa St,
Whiteriver, AZ 85941

Phone

(928) 338-4858

NPI assigned

Mar 13, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coleman Professional Services, Inc. 64 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  OH, Professional

  Medicare reassignment Care Compare group NPD
• Tribal Counseling and Consulting Inc.

  • Professional Counselor
  • Kenton, OH
  • NPI 1154280816

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1154880862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "859411790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W PONDEROSA ST,",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-4858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 E Eliza St",
            "address_purpose": "LOCATION",
            "city": "Kenton",
            "state": "OH",
            "postal_code": "433261486",
            "country_code": "US",
            "telephone_number": "419-675-2243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATOLE",
        "first_name": "IVAN",
        "name_suffix": "III",
        "credential": "LPC/LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2404839-SUPV",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0017086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VJ546645",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Andres, PHARMD
• Apache Behavioral Health Services
• Apache Behavioral Health Services, Inc.
• James George Ard, D.O.
• Rowdy R Atkinson, PHARMD
• Travis Wade Austin, M.D.
• Cenk Ayral, MAED. BSN CDE
• Ashkan Bahin-Aein, MD
• Hana Bakalli
• Michelle Joann Barbosa, PHARMD

• All providers in Whiteriver, AZ
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.