Alvin Lloyd Winegar Jr., LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMSW-31995 Issued in ID

Practice address

310 N 2ND E
Suite 128
Rexburg, ID 83440-1600

Phone

(208) 709-6257

Fax

(208) 356-5675

NPI assigned

Jul 29, 2013

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• South Fork Services, LLC

  • Community/Behavioral Health Agency
  • Rexburg, ID
  • NPI 1588006217
  NPD (past)

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1982046173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 2ND E",
            "address_2": "SUITE 128",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401600",
            "telephone_number": "208-709-6257",
            "fax_number": "208-356-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 2ND E",
            "address_2": "SUITE 128",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401600",
            "telephone_number": "208-709-6257",
            "fax_number": "208-356-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINEGAR",
        "first_name": "ALVIN",
        "middle_name": "LLOYD",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-31995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Chant Williams, DC
• Michael D. Williams, LMFT
• Kory David Wilson, CMHC-7172909-6004
• Melissa Madelyn Wilson
• Rebecca Jean Wilson, M.S., CCC-SLP
• Ashley Winegar, FNP
• Geoffrey R Winfree, LMFT
• Ashlyn Winters
• Chelsea S Winters, PTA
• Shane Ellis Withers, RPH

• Mental Health Counselor in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.