Individual provider Active NPI

Devona Marie Mahal, LPC

  • Marriage & Family Therapist
  • Coeur d'Alene, ID
National Provider Identifier
1164976114
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LPC-6254 Issued in ID
Practice address
101 W Ironwood Dr Ste 216
Coeur D Alene, ID 83814-1406
Phone
(208) 691-1365
NPI assigned
Aug 8, 2016
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LPC-6254 ID Primary

Addresses

Primary practice location

101 W Ironwood Dr Ste 216
Coeur D Alene, ID 83814-1406

Mailing address

101 W Ironwood Dr Ste 216
Coeur D Alene, ID 83814-1406
Phone (208) 691-1365

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

LicenseStateTypeSpecialty
LPC-6254IDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Navigation Counseling CurrentSince Mar 24, 2024 Accepting new patients
Integrated Interventions Past Accepting new patients

Locations

101 W Ironwood Dr
Ste 216
Coeur D Alene, ID 83814
Phone (208) 691-1365

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1164976114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W IRONWOOD DR STE 216",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838141406",
            "telephone_number": "208-691-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W IRONWOOD DR STE 216",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838141406",
            "telephone_number": "208-691-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAL",
        "first_name": "DEVONA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LPC-6254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.