Individual provider Active NPI

Michael Edwards, M.A., LCPC, LAC

  • Mental Health Counselor
  • Whitefish, MT
National Provider Identifier
1376664359
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
736 Issued in NH
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

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
77066380NH01OtherANTHEM

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240227004167 MT Practitioner - Mental Health Counselor 4385089580 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
BBH-LAC-LIC-13219MTMDAddiction (Substance Use Disorder) Counselor
650NHMDAddiction (Substance Use Disorder) Counselor
BBH-LCPC-LIC-13148MTMDMental Health Counselor
736NHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Logan Health - Whitefish CurrentSince Jan 1, 2024 Accepting new patients
Logan Health - Whitefish Current Accepting new patients
Logan Health - Whitefish CurrentSince Jan 1, 2024 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.

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

Verify at the official NPI Registry.