Individual provider Active NPI

Vanessa Hanson, LCPC

  • Counselor
  • Chubbuck, ID
National Provider Identifier
1669719464
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LCPC-6839 Issued in ID
Practice address
265 E Chubbuck Road
Chubbuck, ID 83202-5055
Phone
(208) 237-1711
Fax
(208) 237-9806
NPI assigned
Jan 14, 2013
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Counselor 101Y00000X LCPC-6839 ID Primary

Addresses

Primary practice location

265 E Chubbuck Road
Chubbuck, ID 83202-5055

Mailing address

265 E Chubbuck Road
Chubbuck, ID 83202-5055
Phone (208) 237-1711

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
I20240202003426 ID Practitioner - Mental Health Counselor 2567805880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center Counseling LLCGroup PAC ID 6709165442, 15 clinicians

Practice addresses (Care Compare)

20 Hillcrest Ave
American Falls, ID 83211-1180
Phone (208) 237-1711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-6839IDMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center Counseling, LLC CurrentSince Jan 1, 2024 Accepting new patients
Hope Tree Inc PastSince Apr 23, 2017 Accepting new patients

Locations

265 E Chubbuck Rd
Chubbuck, ID 83202
Phone (208) 237-1711

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1669719464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E CHUBBUCK ROAD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025055",
            "telephone_number": "208-237-1711",
            "fax_number": "208-237-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E CHUBBUCK ROAD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025055",
            "telephone_number": "208-237-1711",
            "fax_number": "208-237-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "VANESSA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-14",
        "last_updated": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-6839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

Verify at the official NPI Registry.