Susan K Macomb, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC-6826 Issued in ID

Practice address

500 S 11TH Ave, Ste 402a
Pocatello, ID 83201-4880

Phone

(208) 242-2335

Fax

(208) 242-2344

NPI assigned

Aug 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Insight Wellness & Counseling, LLC

  • Professional Counselor
  • Pocatello, ID
  • NPI 1154018026
  NPD (past) Authorized official

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1265624100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE, STE 402A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014880",
            "telephone_number": "208-242-2335",
            "fax_number": "208-242-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE, STE 402A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014880",
            "telephone_number": "208-242-2335",
            "fax_number": "208-242-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACOMB",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-09-06",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "3891",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-6826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg A Maag, BSPHARM
• Alyssa Mabey
• Megan L. Macbutch, PA-C
• Elizabeth Macklin, LCPC
• Justine Marion Macneil, M.D.
• David M Madden, M.D.
• Emily Sarah Magni, LMSW
• John Felix Mahaffey
• Colin Mahoney, SE
• Maior Telehealth LLC

• Professional Counselor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.