Avalon Counseling, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AVALON COUNSELING, LLC

Practice address

1250 W Ironwood Dr Ste 303
Coeur D Alene, ID 83814-2682

Phone

(208) 366-5053

Fax

(208) 518-1258

NPI assigned

Aug 24, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Lonnie M Stapp, PH.D.NPI 1538539697

Title

Clinical Director

Phone

(208) 771-5911

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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

• Lonnie M Stapp, LCPC

  • Mental Health Counselor
  • Coeur D Alene, ID
  • NPI 1538539697

  ID

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566604800000",
    "number": "1366099236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 303",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "208-771-5911",
            "fax_number": "208-518-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 303",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "208-366-5053",
            "fax_number": "208-518-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-24",
        "last_updated": "2019-08-24",
        "status": "A",
        "authorized_official_last_name": "STAPP",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "208-771-5911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Coeur D Alene, ID
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2019; 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.