Individual provider Active NPI

Mitchell Ray Barney, LSMW

  • Mental Health Counselor
  • Idaho Falls, ID
National Provider Identifier
1225624281
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMSW-41015 Issued in ID
Practice address
1820 E 17TH St Ste 115
Idaho Falls, ID 83404-6472
Phone
(208) 520-7074
Fax
(208) 970-6188
NPI assigned
Dec 14, 2020
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMSW-41015 ID Primary
Social Worker 104100000X LMSW-41015 ID

Addresses

Primary practice location

1820 E 17TH St Ste 115
Idaho Falls, ID 83404-6472

Mailing address

1820 E 17TH St Ste 115
Idaho Falls, ID 83404-6472
Phone (208) 520-7074

Other practice location 1

275 S 5th Ave Ste 146
Pocatello, ID 83201-6400
Phone (208) 696-2628

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
LMSW-41015IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey Mental Wellness PC CurrentSince Nov 7, 2025 Accepting new patients

Locations

482 Constitution Way
Ste 109
Idaho Falls, ID 83402
Phone (208) 696-2628

1820 E 17th St
Ste 115
Idaho Falls, ID 83404

275 S 5th Ave
Ste 146
Pocatello, ID 83201
Phone (208) 696-2628

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, 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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1225624281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E 17TH ST STE 115",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046472",
            "telephone_number": "208-520-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E 17TH ST STE 115",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046472",
            "telephone_number": "208-520-7074",
            "fax_number": "208-970-6188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 S 5th Ave Ste 146",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832016400",
            "country_code": "US",
            "telephone_number": "208-696-2628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNEY",
        "first_name": "MITCHELL",
        "middle_name": "RAY",
        "credential": "LSMW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-41015",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-41015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.