Unknown Individual – Mental Health Counselor, NPI 1770825499

Mental Health Counselor

Unknown Individual is a healthcare provider. based in Idaho falls, Idaho. specializing in Mental Health Counselor. They hold a License No. LCSW 32450 (ID). The NPI Number for Unknown Individual is 1770825499

Main info

Organization

Inactive

14 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1770825499

Phone

(208) 523-5319

Address

PO BOX 2106

Deactivation Date

6 August 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2085235319

Graduation Year

2012 (14 years ago)

PAC ID

7214227107

Group Practice PAC ID

3173794187

Professional Enrollment ID

I20160606001131

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

PO BOX 2106
IDAHO FALLS, ID 834032106
Phone: (208) 523-5319
Fax: (208) 523-5627
Type: Mailing
1970 E 17TH ST
SUITE 202
IDAHO FALLS, ID 834048014
Phone: (208) 523-5319
Fax: (208) 523-5627
Type: Location

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 83403)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 3173794187View full group profile

Name	Specialty	State
SUE ROSENBAUM (LCSW)	-	ID
STEPHANIE TOLDSON (LCSW)	-	ID
MRS. KATHY JEAN HEMMING (PA-C)	-	ID

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?

Yes. Unknown Individual is listed with NPI 1770825499 in the public NPI dataset.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Mental Health Counselor in this dataset. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual based?

Unknown Individual is tied to Idaho Falls, Idaho in the data we show; additional addresses may exist on the full record.

Is the information about Unknown Individual up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."