Individual provider Active NPI

Lisa Bunker, LCPC

  • Mental Health Counselor
  • Coeur D Alene, ID
National Provider Identifier
1619510211
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-5433 Issued in ID
Practice address
250 Northwest Blvd Ste 101a
Coeur D Alene, ID 83814-2971
Phone
(917) 385-0520
NPI assigned
Oct 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LCPC-5433 ID
Mental Health Counselor 101YM0800X LCPC-5433 ID Primary

Addresses

Primary practice location

250 Northwest Blvd Ste 101a
Coeur D Alene, ID 83814-2971

Mailing address

703 E Lakeside Ave
Coeur D Alene, ID 83814-4131

Other practice location 1

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-4000

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
I20251222000947 ID Practitioner - Mental Health Counselor 1557856184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-5433IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Nov 9, 2025 Accepting new patients
Kootenai Health, Inc. CurrentSince Nov 9, 2025 Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

Organizations & group practices 3

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": "1572048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1619510211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 E LAKESIDE AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NORTHWEST BLVD STE 101A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142971",
            "telephone_number": "917-385-0520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNKER",
        "first_name": "LISA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-26",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-5433",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-5433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.