Individual provider Active NPI

Mindy Thacker, LPC

  • Professional Counselor
  • Sandpoint, ID
National Provider Identifier
1275478059
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9061679 Issued in ID
Practice address
123 S Third Ave Ste 1
Sandpoint, ID 83864-1358
Phone
(208) 691-4687
Fax
(208) 620-2306
NPI assigned
Apr 20, 2026
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 9061679 ID Primary

Addresses

Primary practice location

123 S Third Ave Ste 1
Sandpoint, ID 83864-1358

Mailing address

211 E Coeur D'Alene Ave
Ste 102
Coeur D'Alene, ID 83814
Phone (208) 699-6817

Other names 1

  • Mindy Jones Other name

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
9061679IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cultivation, LLC Past Accepting new patients
Cultivation, LLC Professional PastSince Jul 12, 2020 Accepting new patients

Organizations & group practices 2

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": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1275478059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E COEUR D'ALENE AVE",
            "address_2": "STE 102",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-699-6817",
            "fax_number": "208-620-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S THIRD AVE STE 1",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641358",
            "telephone_number": "208-691-4687",
            "fax_number": "208-620-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "MINDY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "9061679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "JONES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.