NPIMap

Organization Active NPI

Moonlight Meadows Counseling Center

  • Adult Mental Health Clinic/Center
  • Roberts, ID
National Provider Identifier
1720713100
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MOONLIGHT MEADOWS COUNSELING CENTER
Doing business as
Moonlight Meadows Counseling Center
Practice address
639 N 2858 E
Roberts, ID 83444-5070
Phone
(208) 585-8086
NPI assigned
Jul 20, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Stacie S Karlinsey, LCSWNPI 1356989909
Title
Owner/Therapist
Phone
(208) 585-8086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

639 N 2858 E
Roberts, ID 83444-5070

Mailing address

639 N 2858 E
Roberts, ID 83444-5070
Phone (208) 585-8086

Other names 1

  • Moonlight Meadows Counseling Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1720713100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 N 2858 E",
            "city": "ROBERTS",
            "state": "ID",
            "postal_code": "834445070",
            "telephone_number": "208-585-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 N 2858 E",
            "city": "ROBERTS",
            "state": "ID",
            "postal_code": "834445070",
            "telephone_number": "208-585-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONLIGHT MEADOWS COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "KARLINSEY",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "208-585-8086",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moonlight Meadows Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roberts, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.

Verify at the official NPI Registry.