Individual provider Active NPI

David Alan Josephson, M.S., ACADC

  • Addiction (Substance Use Disorder) Counselor
  • Lewiston, ID
National Provider Identifier
1649457888
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
45-100 Issued in ID
Practice address
111 Main St
Lewiston, ID 83501-2141
Phone
(208) 791-4925
Fax
(509) 758-1028
NPI assigned
Jan 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 45-100 ID Primary

Addresses

Primary practice location

111 Main St
Lewiston, ID 83501-2141

Mailing address

PO Box 761
Clarkston, WA 99403-0761
Phone (208) 791-4925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
45-100IDMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1649457888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994030761",
            "telephone_number": "208-791-4925",
            "fax_number": "509-758-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MAIN ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012141",
            "telephone_number": "208-791-4925",
            "fax_number": "509-758-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPHSON",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "M.S., ACADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "45-100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.