Active NPI
Michael Edwards, M.A., LCPC, LAC
- Mental Health Counselor
- Whitefish, MT
National Provider Identifier
1376664359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 736
- Practice address
- 2004 Hospital Way
Whitefish, MT 59937-7858 - Phone
- (406) 862-1030
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | BBH-LCPC-LIC-13148 | MT | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | BBH-LAC-LIC-13219 | MT | |
| Mental Health Counselor | 101YM0800X | 736 | NH | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 650 | NH |
Addresses
Primary practice location
2004 Hospital Way
Whitefish, MT 59937-7858
Mailing address
2004 Hospital Way
Whitefish, MT 59937-7858
Phone (406) 862-1030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77066380NH01 | Other | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-LAC-LIC-13219 | MT | MD | Addiction (Substance Use Disorder) Counselor |
| 650 | NH | MD | Addiction (Substance Use Disorder) Counselor |
| BBH-LCPC-LIC-13148 | MT | MD | Mental Health Counselor |
| 736 | NH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logan Health - Whitefish | Current | Accepting new patients | |
| Logan Health - Whitefish | Current | Accepting new patients | |
| Logan Health - Whitefish | Current | Accepting new patients | |
| Logan Health - Whitefish | Past | Accepting new patients |
Locations
2004 Hospital Way
Whitefish, MT 59937
Phone (406) 862-1030
1600 Hospital Way
Whitefish, MT 59937
Phone (406) 863-3500
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Whitefish, MT
- NPI 1356317432
-
- Critical Access Hospital
- Whitefish, MT
- NPI 1396710851
-
- Psychiatry Physician
- Whitefish, MT
- NPI 1487085098
-
- Rural Health Clinic/Center
- Eureka, MT
- NPI 1336115849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454630400000",
"number": "1376664359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2004 HOSPITAL WAY",
"city": "WHITEFISH",
"state": "MT",
"postal_code": "599377858",
"telephone_number": "406-862-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2004 HOSPITAL WAY",
"city": "WHITEFISH",
"state": "MT",
"postal_code": "599377858",
"telephone_number": "406-862-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "MICHAEL",
"credential": "M.A., LCPC, LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2016-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "BBH-LCPC-LIC-13148",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "BBH-LAC-LIC-13219",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NH",
"license": "736",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NH",
"license": "650",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "77066380NH01",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Whitefish, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.