Flow State Psychotherapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

FLOW STATE PSYCHOTHERAPY, LLC

Practice address

613 N River St Ste 1a
Hailey, ID 83333-8438

Phone

(406) 546-2025

NPI assigned

Mar 17, 2021

Last updated

Mar 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lydia Missal, LCPCNPI 1083959332

Title

Owner/Provider

Phone

(406) 546-2025

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lydia Jo Missal, LCPC

  • Professional Counselor
  • Hailey, ID
  • NPI 1083959332
  NPD Authorized official
• Lisa Hansen, LMSW

  • Clinical Social Worker
  • Hailey, ID
  • NPI 1114836046
  NPD (past)

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1891370284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5895",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833335895",
            "telephone_number": "406-546-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 N RIVER ST STE 1A",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338438",
            "telephone_number": "406-546-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOW STATE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "MISSAL",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "406-546-2025",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083959332",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Practice Associates PA Mid Level
• Family Practice Associates, PA
• Marlin Layne Felton, R.PH.
• Peter B Ferrara, MD
• Julianne Fischman, LCSW
• Jesse Foster, DPT
• Frank Andrews, PH.D. PA
• Raquel Galvin
• Debbie M Garratt, FNP-C
• Chelsea Lyn Goodrich, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.