Individual provider Active NPI

Stephani Fae Carlton, LMHC

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1194150722
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60641907 Issued in WA
Practice address
107 S Division St
Spokane, WA 99202-1510
Phone
(509) 838-4651
Fax
(509) 363-2762
NPI assigned
Sep 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG 60393692 WA
Mental Health Counselor 101YM0800X LH60641907 WA Primary
Counselor 101Y00000X MC 60393728 WA
Counselor 101Y00000X LPC-5353 ID

Addresses

Primary practice location

107 S Division St
Spokane, WA 99202-1510

Mailing address

1104 W Ironwood Dr
Coeur D Alene, ID 83814-2605
Phone (208) 676-1003

Other practice location 1

1104 W Ironwood Dr
Coeur D Alene, ID 83814-2605
Phone (208) 676-1003

Other identifiers 1

IdentifierTypeStateIssuer
1194150722MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-5353IDMDCounselor
MC 60393728WAMDCounselor
LH60641907WAMDMental Health Counselor
MG 60393692WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Behavioral Health Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

107 S Division St
Spokane, WA 99202
Phone (509) 383-4651

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194150722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W IRONWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142605",
            "telephone_number": "208-676-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651",
            "fax_number": "509-363-2762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 W Ironwood Dr",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142605",
            "country_code": "US",
            "telephone_number": "208-676-1003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "STEPHANI",
        "middle_name": "FAE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG 60393692",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60641907",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC 60393728",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LPC-5353",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194150722",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.