Active NPI
Melissa Diane Pfenning, M.ED., LCPC
- Mental Health Counselor
- Post Falls, ID
National Provider Identifier
1710200951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCPC 4662
- Practice address
- 1616 E Seltice Way Ste 213
Post Falls, ID 83835-0000 - Phone
- (208) 699-0679
- NPI assigned
- Mar 2, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCPC 4662 | ID | Primary |
Addresses
Primary practice location
1616 E Seltice Way Ste 213
Post Falls, ID 83835-0000
Mailing address
PO Box 3620
Post Falls, ID 83877-0018
Phone (208) 699-0679
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCPC 4662 | Other | ID | STATE OF IDAHO LICENSING BOARD |
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC 4662 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312502400000",
"number": "1710200951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3620",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838770018",
"telephone_number": "208-699-0679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 E SELTICE WAY STE 213",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838350000",
"telephone_number": "208-699-0679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFENNING",
"first_name": "MELISSA",
"middle_name": "DIANE",
"credential": "M.ED., LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-02",
"last_updated": "2011-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCPC 4662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF IDAHO LICENSING BOARD",
"identifier": "LCPC 4662",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Post Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.