NPIMap

Organization Active NPI

Overcomer Christian Counseling

  • Mental Health Counselor
  • Lewiston, ID
National Provider Identifier
1659030716
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
OVERCOMER CHRISTIAN COUNSELING
Doing business as
Overcomer Christian Counseling
Practice address
0309 2ND St
Lewiston, ID 83501-2163
Phone
(208) 746-0137
Fax
(208) 746-8685
NPI assigned
Dec 15, 2021
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Mr. Brandon Clark, LCSWNPI 1932561115
Title
Owner/Therapist
Phone
(208) 746-0137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

0309 2ND St
Lewiston, ID 83501-2163

Mailing address

0309 2ND St
Lewiston, ID 83501-2163
Phone (208) 746-0137

Other names 1

  • Overcomer Christian Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

0309 2nd St
Lewiston, ID 83501
Phone (208) 746-0026

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1659030716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0309 2ND ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012163",
            "telephone_number": "208-746-0137",
            "fax_number": "208-746-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "0309 2ND ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012163",
            "telephone_number": "208-746-0137",
            "fax_number": "208-746-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERCOMER CHRISTIAN COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "208-746-0137",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overcomer Christian Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 15, 2021; 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.