Active NPI
Carly Romney
- Mental Health Counselor
- Rexburg, ID
National Provider Identifier
1790200491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6578
- Practice address
- 420 W 4TH S
Rexburg, ID 83440-2319 - Phone
- (208) 656-4017
- NPI assigned
- Aug 3, 2017
- 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 | 6578 | ID | Primary |
Addresses
Primary practice location
420 W 4TH S
Rexburg, ID 83440-2319
Mailing address
2275 W Broadway St Ste G
Idaho Falls, ID 83402-2902
Phone (208) 524-7400
Other practice location 1
295 N 3855 E
Rigby, ID 83442-5124
Phone (208) 745-5205
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 |
|---|---|---|---|
| 6578 | ID | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tueller Counseling Inc | Past | Accepting new patients | |
| Tueller Counseling Inc | Past | Accepting new patients | |
| Tueller Counseling Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Idaho Falls, ID
- NPI 1477766905
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rigby, ID
- NPI 1699566356
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rexburg, ID
- NPI 1861283525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1790200491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 W BROADWAY ST STE G",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834022902",
"telephone_number": "208-524-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W 4TH S",
"city": "REXBURG",
"state": "ID",
"postal_code": "834402319",
"telephone_number": "208-656-4017"
}
],
"practiceLocations": [
{
"address_1": "295 N 3855 E",
"address_purpose": "LOCATION",
"city": "Rigby",
"state": "ID",
"postal_code": "834425124",
"country_code": "US",
"telephone_number": "208-745-5205",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROMNEY",
"first_name": "CARLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-03",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "6578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.