Cody Lee Carlson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2275 W Broadway St Ste G
Idaho Falls, ID 83402-2902

Phone

(208) 524-7400

NPI assigned

Jul 23, 2018

Last updated

Jul 23, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tueller Counseling IncGroup PAC ID 0547585895, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1477766905

  Counselor

  Medicare reassignment Care Compare group NPD
• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rigby, ID
  • NPI 1699566356
  NPD (past)
• Tueller Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rexburg, ID
  • NPI 1861283525
  NPD (past)

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1790262871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 DAVIS CIR",
            "city": "IONA",
            "state": "ID",
            "postal_code": "834275501",
            "telephone_number": "208-709-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 W BROADWAY ST STE G",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022902",
            "telephone_number": "208-524-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CODY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Capson
• Cardiac Cath Lab of Idaho Falls
• Kylee Cardon
• Carepoint Inpatient Blue Sky Neurology Idaho, LLC
• Kryston Chenay Carling, PHARMD
• Jessica C. Carlson, L.P.C.
• Julie Ann Carlson, LCSW
• Kamryn Judith Carlson, LMSW
• Carmen Hernandez Radford
• Cathryn D Carpenter

• Professional Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.