Joe A Andersen, LPC
Individual provider Active NPI Professional Counselor · Idaho Falls, ID
NPI 1629308671 · NPPES record last updated Jul 29, 2025
Key facts
- NPI
- 1629308671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC4350 (ID)
- Practice address
- 2088 E 25TH St
Idaho Falls, ID 83404-6490 - Phone
- (208) 528-7655
- NPI assigned
- Jan 13, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Mental Health Specialists
Practice addresses (Care Compare)
210 W Burnside Ave
Suite a
Pocatello, ID 83202-4916
Phone (208) 238-9000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240108005879 | ID | Practitioner - Mental Health Counselor | 8628429222 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC4350 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialists | Professional | Current |
Accepting new patients |
Locations
210 W Burnside Ave
Ste A
Pocatello, ID 83202
Phone (208) 238-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC4350 | ID | Yes |
Addresses
Primary practice location
2088 E 25TH St
Idaho Falls, ID 83404-6490
Mailing address
2088 E 25TH St
Idaho Falls, ID 83404-6490
Phone (208) 528-7655
Other providers in Idaho Falls, ID
- Amplify Optometry of America PLLC
- John L Andary
- Sterling Don Andelin
- Bryce Wade Andersen
- David Lynn Andersen
- Mikayla Andersen
- Carol V Anderson
- Cola Anderson
- David Ray Anderson
- Heather Annette Anderson
All providers in Idaho Falls, ID · Professional Counselor in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.