Individual provider Active NPI

Michael Don Unruh, LCPC

  • Mental Health Counselor
  • Coeur d'Alene, ID
National Provider Identifier
1770838989
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-4965 Issued in ID
Practice address
923 E Sherman Ave
Suite 200
Coeur D Alene, ID 83814-4938
Phone
(208) 953-1403
NPI assigned
Jul 13, 2012
Last updated
Jul 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCPC-4965 ID Primary

Addresses

Primary practice location

923 E Sherman Ave
Suite 200
Coeur D Alene, ID 83814-4938

Mailing address

6245 N Cezanne Dr
Coeur D Alene, ID 83815-9132
Phone (208) 953-1403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20260528003371 WA Practitioner - Mental Health Counselor 0648740811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 N Main St
Coupeville, WA 98239-3413

105 NE Faris St
Coupeville, WA 98239-3556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-4965IDMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1770838989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 N CEZANNE DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159132",
            "telephone_number": "208-953-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 E SHERMAN AVE",
            "address_2": "SUITE 200",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144938",
            "telephone_number": "208-953-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNRUH",
        "first_name": "MICHAEL",
        "middle_name": "DON",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-4965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.