NPIMap

Organization Active NPI

Mark R Jones Dba Clearwater Counseling

  • Community/Behavioral Health Agency
  • Lewiston, ID
National Provider Identifier
1972685915
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MARK R JONES DBA CLEARWATER COUNSELING
Practice address
1020 Main St
Lewiston, ID 83501-1842
Phone
(208) 743-8101
Fax
(208) 746-7402
NPI assigned
Oct 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mark R Jones, LCSW
Title
Owner
Phone
(208) 943-8101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X ID Primary

Addresses

Primary practice location

1020 Main St
Lewiston, ID 83501-1842

Mailing address

1020 Main
Lewiston, ID 83504-1842
Phone (208) 743-8101

Other identifiers 7

IdentifierTypeStateIssuer
807373700MedicaidID
010100018983OtherIDREGENCE BLUESHEILD
807347200MedicaidID
8H492OtherIDBLUE CROSS OF IDAHO
000010143998OtherIDBLUE CROSS BLUESHIELD
805879700MedicaidID
807346600MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Mark R Jones13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972685915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MAIN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835041842",
            "telephone_number": "208-743-8101",
            "fax_number": "208-746-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MAIN ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011842",
            "telephone_number": "208-743-8101",
            "fax_number": "208-746-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R JONES DBA CLEARWATER COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-943-8101",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807373700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHEILD",
            "identifier": "010100018983",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807347200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8H492",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHIELD",
            "identifier": "000010143998",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805879700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807346600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.