Active NPI
Melissa Odegard, LPC
- Counselor
- Pocatello, ID
National Provider Identifier
1710197942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 500 S 11TH Ave
Suite 302
Pocatello, ID 83201-4835 - Phone
- (208) 233-0150
- NPI assigned
- May 23, 2007
- Last updated
- Sep 11, 2025
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary | |
| Mental Health Counselor | 101YM0800X | LPC369 | ID |
Addresses
Primary practice location
500 S 11TH Ave
Suite 302
Pocatello, ID 83201-4835
Mailing address
455 N 16TH Ave
Pocatello, ID 83201-4053
Phone (208) 236-1600
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 |
|---|---|---|---|
| LPC369 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1710197942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 N 16TH AVE",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014053",
"telephone_number": "208-236-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S 11TH AVE",
"address_2": "SUITE 302",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014835",
"telephone_number": "208-233-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODEGARD",
"first_name": "MELISSA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC369",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.