Active NPI
Julie M Thompson, LPC
- Professional Counselor
- Bethel, AK
National Provider Identifier
1679763031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-3885
- Practice address
- 1410 Calista Drive
Bethel, AK 99559 - Phone
- (907) 543-6730
- Fax
- (907) 543-6712
- NPI assigned
- Jul 31, 2007
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-3885 | ID | |
| Professional Counselor | 101YP2500X | LPC-3885 | AK | Primary |
Addresses
Primary practice location
1410 Calista Drive
Bethel, AK 99559
Mailing address
P.O. Box 528
Attn: BH Ayagnirvik Healing Center
Bethel, AK 99559
Phone (907) 543-6730
Other practice location 1
2375 E Sunnyside Rd Ste C
Idaho Falls, ID 83404-8281
Phone (208) 529-5777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-3885 | ID | MD | Mental Health Counselor |
| LPC-3885 | AK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1679763031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 528",
"address_2": "ATTN: BH AYAGNIRVIK HEALING CENTER",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6730",
"fax_number": "907-543-6712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 CALISTA DRIVE",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6730",
"fax_number": "907-543-6712"
}
],
"practiceLocations": [
{
"address_1": "2375 E Sunnyside Rd Ste C",
"address_purpose": "LOCATION",
"city": "Idaho Falls",
"state": "ID",
"postal_code": "834048281",
"country_code": "US",
"telephone_number": "208-529-5777",
"fax_number": "208-529-5778",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "JULIE",
"middle_name": "M",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-31",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC-3885",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AK",
"license": "LPC-3885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1020986",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.