Individual provider Active NPI

David Barth, LCPC

  • Mental Health Counselor
  • Coeur D Alene, ID
National Provider Identifier
1558784108
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-6718 Issued in ID
Practice address
1018 E Front Ave
Coeur D Alene, ID 83814-4018
Phone
(406) 847-5095
NPI assigned
Jan 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 LCPC-6718 ID Primary

Addresses

Primary practice location

1018 E Front Ave
Coeur D Alene, ID 83814-4018

Mailing address

417 S Lavina Ave
Sandpoint, ID 83864-1144
Phone (208) 304-1102

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240131004375 ID Practitioner - Mental Health Counselor 2163875659 Practice locations: Sandpoint, ID

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 E Lake St
Suite 205
Sandpoint, ID 83864-1366
Phone (208) 304-7980

417 S Lavina Ave
Sandpoint, ID 83864-1144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-6718IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Watershed Wellness, LLC CurrentSince Jul 23, 2023 Accepting new patients

Locations

120 E Lake St
Ste 205
Sandpoint, ID 83864
Phone (208) 304-1102

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": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1558784108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S LAVINA AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641144",
            "telephone_number": "208-304-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 E FRONT AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144018",
            "telephone_number": "406-847-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTH",
        "first_name": "DAVID",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-31",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-6718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.