NPIMap

Organization Active NPI

Powder Basin Associates

  • Mental Health Counselor
  • Kellogg, ID
National Provider Identifier
1184881153
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
POWDER BASIN ASSOCIATES
Practice address
204 Oregon St
Kellogg, ID 83837-5008
Phone
(208) 783-0427
Fax
(208) 783-1387
NPI assigned
May 19, 2008
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Lynn A Moore, CPC
Title
Owner President
Phone
(208) 209-0535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

204 Oregon St
Kellogg, ID 83837-5008

Mailing address

7905 N Meadowlark Way
Suite E
Coeur D Alene, ID 83815-5041
Phone (208) 209-0535

Other identifiers 1

IdentifierTypeStateIssuer
807277200MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Powder Basin Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1184881153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7905 N MEADOWLARK WAY",
            "address_2": "SUITE E",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838155041",
            "telephone_number": "208-209-0535",
            "fax_number": "208-209-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 OREGON ST",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838375008",
            "telephone_number": "208-783-0427",
            "fax_number": "208-783-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWDER BASIN ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "208-209-0535",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807277200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kellogg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.