Individual provider Active NPI

Suzanne E Brown, LMSW

  • Mental Health Counselor
  • Idaho Falls, ID
National Provider Identifier
1881963841
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMSW31646 Issued in ID
Practice address
2420 E 25TH St
Idaho Falls, ID 83404-7549
Phone
(208) 542-1026
Fax
(208) 526-2945
NPI assigned
Dec 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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 LMSW31646 ID Primary

Addresses

Primary practice location

2420 E 25TH St
Idaho Falls, ID 83404-7549

Mailing address

2420 E 25TH St
Idaho Falls, ID 83404-7549
Phone (208) 542-1026

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
I20150824002229 ID Practitioner - Clinical Social Worker 3375859176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Country Behavioral HealthGroup PAC ID 0648454587, 44 clinicians

Practice addresses (Care Compare)

1248 E 17TH St
Idaho Falls, ID 83404-6147
Phone (208) 542-1026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW31646IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Behavioral Health CurrentSince Feb 1, 2020 Accepting new patients
High Country Behavioral Health CurrentSince Feb 1, 2020 Accepting new patients

Locations

1248 E 17th St
Idaho Falls, ID 83404
Phone (208) 542-1026

2420 E 25th St
Idaho Falls, ID 83404
Phone (208) 542-1026

420 S 4th Ave
Pocatello, ID 83201
Phone (208) 478-9081

Organizations & group practices 2

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": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1881963841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047549",
            "telephone_number": "208-542-1026",
            "fax_number": "208-526-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047549",
            "telephone_number": "208-542-1026",
            "fax_number": "208-526-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SUZANNE",
        "middle_name": "E",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW31646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.