STEPHANIE LEE BRANNON (LCPC) – Addiction (Substance Use Disorder) Counselor, NPI 1285149732
Addiction (Substance Use Disorder) Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
436 MENTAL HEALTH COUNSELOR in ID
Provider Addresses for STEPHANIE LEE BRANNON (LCPC)
453, South Indiana Street, Boyle Heights, Los Angeles, Los Angeles County, California, 90063, United States
LOS ANGELES, CA 900633908
Phone: (626) 332-3145
Type: Mailing
210 W BURNSIDE AVE STE A
CHUBBUCK, ID 832024916
Phone: (208) 238-9000
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-02-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240212003108 | I | Mental Health Counselor | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90063)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | ID | |
| Clinical Social Worker | ID | |
| Mental Health Counselor | ID | |
| Mental Health Counselor | AK | |
| Mental Health Counselor | ID | |
| Clinical Social Worker | ID | |
| Clinical Social Worker | MN | |
| Nurse Practitioner | ID | |
| Mental Health Counselor | ID | |
| - | WY |
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