Mountain Lake Counseling and Support Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC-3664 Issued in ID

Legal business name

MOUNTAIN LAKE COUNSELING AND SUPPORT SERVICES, INC.

Practice address

804 Airport Way
Sandpoint, ID 83864-8200

Phone

(208) 597-3553

NPI assigned

May 9, 2008

Last updated

May 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

M. Mikell Zimmerman

Title

President

Phone

(208) 597-3553

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Mikell Zimmerman, M.S.

  • Professional Counselor
  • Sandpoint, ID
  • NPI 1023288974
  NPD (past)

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1336316207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 AIRPORT WAY",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838648200",
            "telephone_number": "208-597-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 AIRPORT WAY",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838648200",
            "telephone_number": "208-597-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAKE COUNSELING AND SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "M. MIKELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-597-3553"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-3664",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": "LPC-3664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delaney Morehouse, N.D.
• Casandra Morelli
• Angella Rae Morlen
• Robin Morrell, L.M.S.W.
• Elizabeth A Morris, OTR/L
• Mountain View Family Medicine Inc.
• Mountain View Physical Therapy, PC
• Mountain Vision Eye Care
• Daniele Nicole Mrozek, PT, DPT
• Jason Munzke, L.C.P.C.

• Community/Behavioral Health Agency in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.