Northwest Professionals Family Resource Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

NORTHWEST PROFESSIONALS FAMILY RESOURCE CENTER

Practice address

6540 W Emerald St
Suite 100
Boise, ID 83704-8782

Phone

(208) 376-0979

Fax

(208) 378-1089

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By 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

Monty Moore-Johnson, LCPCNPI 1801939533

Title

Owner

Phone

(208) 376-0979

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Monty L Moore Johnson, LCPC

  • Mental Health Counselor
  • Boise, ID
  • NPI 1801939533
  NPD (past) Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356564405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44689",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837110689",
            "telephone_number": "208-376-0979",
            "fax_number": "208-378-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 W EMERALD ST",
            "address_2": "SUITE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048782",
            "telephone_number": "208-376-0979",
            "fax_number": "208-378-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PROFESSIONALS FAMILY RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE-JOHNSON",
        "authorized_official_first_name": "MONTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-376-0979",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8L105",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.