Mira Lee Nielson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8241727 Issued in ID

Practice address

420 W 4TH S
Rexburg, ID 83440-2319

Phone

(208) 656-4017

NPI assigned

Feb 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tueller Counseling IncGroup PAC ID 0547585895, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1477766905
  Medicare reassignment Care Compare group NPD
• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rexburg, ID
  • NPI 1861283525
  NPD

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1447956966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 LINCOLN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014156",
            "telephone_number": "530-566-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 4TH S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402319",
            "telephone_number": "208-656-4017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2275 W Broadway St Ste G",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834022902",
            "country_code": "US",
            "telephone_number": "208-524-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "MIRA",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "8241727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrance Nelson
• Trevor James Nelson, LCSW
• Tyrel Nelson, PT
• Rebecca NG
• Dennis V Nguyen, RD
• Night Boat PLLC
• Norco, Inc
• Erika Nordfelt, LCPC
• Shelby Elizabeth Nordmann, MD
• North Fork Counseling Services, LLC

• Mental Health Counselor in Rexburg, ID
• Providers in Rexburg, 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 Dec 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.