Individual provider Active NPI

Mona Kim-Brown, LCPC

  • Professional Counselor
  • Bonners Ferry, ID
National Provider Identifier
1316024748
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LCPC-327 Issued in ID
Practice address
6615 Comanche St
Bonners Ferry, ID 83805
Phone
(208) 267-1718
Fax
(208) 267-7739
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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 LCPC-327 ID Primary

Addresses

Primary practice location

6615 Comanche St
Bonners Ferry, ID 83805

Mailing address

PO Box 2160
Sandpoint, ID 83864-0908
Phone (208) 267-1718

Other identifiers 1

IdentifierTypeStateIssuer
806590100MedicaidID

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
LCPC-327IDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1316024748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2160",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640908",
            "telephone_number": "208-267-1718",
            "fax_number": "208-267-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 COMANCHE ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "83805",
            "telephone_number": "208-267-1718",
            "fax_number": "208-267-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-BROWN",
        "first_name": "MONA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806590100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonners Ferry, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.