Individual provider Active NPI

Desirae Britton, LPC

  • Mental Health Counselor
  • Coeur D Alene, ID
National Provider Identifier
1215260682
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-3726 Issued in ID
Practice address
1042 W Mill Ave
Ste 205
Coeur D Alene, ID 83814-2489
Phone
(208) 446-9733
Fax
(208) 292-4544
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-3726 ID Primary

Addresses

Primary practice location

1042 W Mill Ave
Ste 205
Coeur D Alene, ID 83814-2489

Mailing address

12852 E Shadow LN
Athol, ID 83801-5065
Phone (208) 818-0532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 28, 2024 through Feb 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-3726IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1215260682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12852 E SHADOW LN",
            "city": "ATHOL",
            "state": "ID",
            "postal_code": "838015065",
            "telephone_number": "208-818-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 W MILL AVE",
            "address_2": "STE 205",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142489",
            "telephone_number": "208-446-9733",
            "fax_number": "208-292-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTON",
        "first_name": "DESIRAE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-3726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.