John D Stephenson, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW-26187 Issued in ID

Practice address

1309 Camas St
Blackfoot, ID 83221-3060

Phone

(208) 782-0675

Fax

(208) 782-0678

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Stillwaters Counseling LLC

  • Mental Health Counselor
  • Blackfoot, ID
  • NPI 1275638645
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1528126158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832210903",
            "telephone_number": "208-782-0675",
            "fax_number": "208-782-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 CAMAS ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832213060",
            "telephone_number": "208-782-0675",
            "fax_number": "208-782-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-26187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806939500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807352800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• State of Idaho Department of Health and Welfare
• State of Idaho Department of Health and Welfare
• State of Idaho Department of Health and Welfare
• State of Idaho Department of Health and Welfare
• Shantel Steffler, MS, APRN, FNP-C
• Zane Christian Stephenson
• Dee Scott Stevens, D.C.
• Stewards of Recovery
• Tyce Alden Stewart, DPT
• Still Waters Counseling

• Mental Health Counselor in Blackfoot, ID
• Providers in Blackfoot, 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 Aug 4, 2014; 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.