Individual provider Active NPI

John Patrick O'Neal, LCPC

  • Professional Counselor
  • Idaho Falls, ID
National Provider Identifier
1710318480
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LCPC-7346 Issued in ID
Practice address
7173 Nugget Creek
Idaho Falls, ID 83406-8282
Phone
(208) 209-2329
NPI assigned
Dec 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LCPC-7346 ID Primary

Addresses

Primary practice location

7173 Nugget Creek
Idaho Falls, ID 83406-8282

Mailing address

7173 Nugget Creek
Idaho Falls, ID 83406-8282
Phone (208) 209-2329

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
I20240205000887 ID Practitioner - Mental Health Counselor 8628411998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Sage Services LLCGroup PAC ID 8527341007, 4 clinicians

Practice addresses (Care Compare)

211 S Woodruff Ave
Suite A3
Idaho Falls, ID 83401-4865
Phone (208) 524-4818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Sage Services LLC Counselor CurrentSince Jan 1, 2024 Accepting new patients
Alliance Home Health of Idaho, LLC PastSince Jan 1, 2024 Accepting new patients

Locations

211 S Woodruff Ave
Ste A3
Idaho Falls, ID 83401
Phone (208) 524-4818

440 E Clark St
Ste A
Pocatello, ID 83201
Phone (208) 233-1276

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1710318480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7173 NUGGET CREEK",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834068282",
            "telephone_number": "208-209-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7173 NUGGET CREEK",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834068282",
            "telephone_number": "208-209-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-06",
        "last_updated": "2024-01-18",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-7346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.