Active NPI
Nicole Konen
- Mental Health Counselor
- Moscow, ID
National Provider Identifier
1164711958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC946
- Practice address
- 200 S Almon St
Suite #204
Moscow, ID 83843-2098 - Phone
- (208) 310-4578
- NPI assigned
- Apr 1, 2011
- Last updated
- Sep 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | LPC946 | ID | Primary |
Addresses
Primary practice location
200 S Almon St
Suite #204
Moscow, ID 83843-2098
Mailing address
200 S Almon St
Suite #204
Moscow, ID 83843-2098
Phone (208) 310-4578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC946 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1164711958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S ALMON ST",
"address_2": "SUITE #204",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838432098",
"telephone_number": "208-310-4578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S ALMON ST",
"address_2": "SUITE #204",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838432098",
"telephone_number": "208-310-4578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONEN",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-01",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.