Healthy Place Counseling, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-2788 Issued in ID

Legal business name

HEALTHY PLACE COUNSELING, INC.

Practice address

255 B St
Suite 300
Idaho Falls, ID 83402-3566

Phone

(208) 524-4818

NPI assigned

Mar 14, 2007

Last updated

Feb 23, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kirk R. Korenke, LCPC

Title

Owner

Phone

(208) 200-4818

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent Angel Ellsworth, PA-C

  • Physician Assistant
  • Idaho Falls, ID
  • NPI 1831412063
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1497888713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 B ST",
            "address_2": "SUITE 300",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023566",
            "telephone_number": "208-524-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 B ST",
            "address_2": "SUITE 300",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023566",
            "telephone_number": "208-524-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY PLACE COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "KORENKE",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-200-4818",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-2788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806909300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Idaho Falls, ID
• Providers in Idaho Falls, 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 Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.