Summit Creek Counseling LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

SUMMIT CREEK COUNSELING LLC

Practice address

57 Bannock St
Malad City, ID 83252-1240

Phone

(208) 220-6534

NPI assigned

Dec 31, 2019

Last updated

Dec 31, 2019By 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

Jodie Barnes, LPCNPI 1831731215

Title

Manager/Member

Phone

(208) 220-6534

Specialties & licenses 1

Addresses

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.

• Jodie Lynn Barnes, LCPC

  • Professional Counselor
  • Preston, ID
  • NPI 1831731215
  NPD Authorized official

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1609415199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "DOWNEY",
            "state": "ID",
            "postal_code": "832340035",
            "telephone_number": "208-220-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BANNOCK ST",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832521240",
            "telephone_number": "208-220-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CREEK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JODIE",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "208-220-6534",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macall Annila Smith, AMFT
• Nacona N Smith
• Southeastern Idaho Medical Clinics (Malad Valley Clinic)
• William Brad Speakman, D.O.
• Dallas R Spencer, LMSW
• Ariel Shantay Avis Taysom, PA-C
• Edgar Blair Thorpe, DDS
• Valley View Counseling LLC
• Russell Lynn Vollmer, LCSW
• Micah Weber, PT, DPT

• Counselor in Malad City, ID
• Providers in Malad City, ID by specialty
• Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.