Individual provider Active NPI

Christine Collaer-Muzzo, LCPC

  • Professional Counselor
  • Pocatello, ID
National Provider Identifier
1851650691
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LCPC-4246 Issued in ID
Practice address
120 S 12TH Ave Ste 4
Pocatello, ID 83201-4814
Phone
(208) 709-0536
NPI assigned
May 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X ID
Professional Counselor 101YP2500X LCPC-4246 ID Primary

Addresses

Primary practice location

120 S 12TH Ave Ste 4
Pocatello, ID 83201-4814

Mailing address

1448 E Center St
Ste A1
Pocatello, ID 83201-4132
Phone (208) 220-6891

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
I20231228002995 ID Practitioner - Mental Health Counselor 2860842150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pray Counseling LLCGroup PAC ID 9537519681, 2 clinicians

Practice addresses (Care Compare)

1448 E Ctr St
Suite A1
Pocatello, ID 83201-4132
Phone (208) 709-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-4246IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pray Counseling, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

1448 E Center St
Ste A1
Pocatello, ID 83201
Phone (208) 220-6891

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1851650691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 E CENTER ST",
            "address_2": "STE A1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014132",
            "telephone_number": "208-220-6891",
            "fax_number": "208-232-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S 12TH AVE STE 4",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014814",
            "telephone_number": "208-709-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAER-MUZZO",
        "first_name": "CHRISTINE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-4246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.