NPIMap

Organization Active NPI

Central Idaho Counseling, PLLC

  • Mental Health Counselor
  • McCall, ID
National Provider Identifier
1275944498
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CENTRAL IDAHO COUNSELING, PLLC
Practice address
125 Commerce St.
Suite B
McCall, ID 83638
Phone
(208) 634-2962
Fax
(208) 634-5064
NPI assigned
May 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Mr. Eric A Mikkelsen, LMFTNPI 1902200819
Title
Owner/Clinician
Phone
(208) 634-2962

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

125 Commerce St.
Suite B
McCall, ID 83638

Mailing address

125 Commerce St.
Suite B
McCall, ID 83638
Phone (208) 634-2962

Other identifiers 2

IdentifierTypeStateIssuer
488228600C1MedicaidID
20002621OtherIDPROVIDER TRANSACTION ACCESS NUMBER

Other names 1

  • Central Idaho Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161215002263 ID Part B Supplier - Clinic/Group Practice 7911287610 Receives reassigned benefits from 1 practitioner
Practice locations: Cascade, ID; Horseshoe Bend, ID; McCall, ID

National Provider Directory

National Provider Directory

Locations

214 S Main St
Cascade, ID 83611
Phone (208) 634-2962

398 School Dr
Horseshoe Bend, ID 83629
Phone (208) 634-2962

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1275944498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COMMERCE ST.",
            "address_2": "SUITE B",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "83638",
            "telephone_number": "208-634-2962",
            "fax_number": "208-634-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COMMERCE ST.",
            "address_2": "SUITE B",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "83638",
            "telephone_number": "208-634-2962",
            "fax_number": "208-634-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IDAHO COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MIKKELSEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "208-634-2962",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488228600C1",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "20002621",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Idaho Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McCall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.