Individual provider Active NPI

Ananda Marie Lettner, LCPC

  • Mental Health Counselor
  • Ammon, ID
National Provider Identifier
1417619552
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8331275 Issued in ID
Practice address
2705 E 17TH St
Ammon, ID 83406-6669
Phone
(208) 346-7500
Fax
(208) 346-7501
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8331275 ID Primary

Addresses

Primary practice location

2705 E 17TH St
Ammon, ID 83406-6669

Mailing address

2705 E 17TH St
Ammon, ID 83406-6601
Phone (208) 346-7500

Other names 1

  • Ananda Marie Easley Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aeasley@pearlhealth.org Direct PEARL HEALTH CLINIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8331275IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Health Clinic Mental Health CurrentSince Sep 1, 2024 Accepting new patients

Locations

2705 E 17th St
Ammon, ID 83406

725 S Woodruff Ave
Ste 101
Idaho Falls, ID 83401

500 S 11th Ave
Ste 203
Pocatello, ID 83201
Phone (208) 232-5902

1350 Baldy Ave
Ste A
Pocatello, ID 83201

Organizations & group practices 1

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": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1417619552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066601",
            "telephone_number": "208-346-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066669",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTNER",
        "first_name": "ANANDA",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "8331275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeasley@pearlhealth.org",
            "affiliation": "Y",
            "endpointDescription": "work email address",
            "affiliationName": "PEARL HEALTH CLINIC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2705 E 17th St",
            "city": "Ammon",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834066601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANANDA",
            "last_name": "EASLEY",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.