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ROBERT ANDREW DE WALL LCPC
NPI 1114228384
Counselor - Professional in Pocatello, ID

Active since November 04, 2010PECOS Enrolled
444 HOSPITAL WAY STE 477, POCATELLO, ID 83201(208) 233-7832(208) 233-7835 Get Directions Write a Review

NPPES record last updated: October 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 22, 2021, Aug 1, 2019 (2 updates tracked since 2019).

About Robert Andrew De Wall Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT ANDREW DE WALL LCPC (NPI 1114228384) is an individual professional provider in Pocatello, Idaho, licensed in Idaho (LCPC-4672) and active in the NPI registry since November 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1114228384
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameROBERT ANDREW DE WALLCredential: LCPC
Location Address444 HOSPITAL WAY STE 477Pocatello, ID 83201-2744
Mailing Address65 Fordham StPocatello, ID 83201-3418 · (208) 317-0027 · Fax (208) 234-2800
Phone(208) 233-7832
Fax(208) 233-7835
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateNovember 4, 2010
Last NPPES UpdateOctober 22, 20212 updates tracked since enumeration
NPPES CertifiedOctober 22, 2021
✔ NPI 1114228384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in ID · LCPC-4672
444 HOSPITAL WAY STE 477, Pocatello, ID 83201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert Andrew De Wall Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577803618
PECOS Enrollment IDI20240105001480
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AMBER CAROLYNN MALAY BS
Case Manager/Care Coordinator
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832
BECKY LOBO
Social Worker
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 236-1600
PORTNEUF VALLEY FAMILY CENTER
Counselor (Professional)
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832
KELLY LIND
Social Worker
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832
OLIVIA THERESA NGADJUI LPC
Counselor (Professional)
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832
TRINETY LYNN CAMPBELL LMSW
Social Worker
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832
COLLETTE CARTER GREGERSEN LPC
Counselor (Professional)
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832
ELIZABETH TORBENSON LPC
Counselor (Professional)
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201
Bannock County (208) 233-7832

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert De Wall's NPI number?

The NPI number for Robert De Wall is 1114228384. It was assigned to this individual provider in the NPPES registry on November 4, 2010.

Where is Robert De Wall located?

Robert De Wall practices at 444 Hospital Way Ste 477, Pocatello, ID 83201. The listed phone number is (208) 233-7832.

What is Robert De Wall's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Robert De Wall enrolled in Medicare?

Yes. Robert De Wall is registered in the Medicare PECOS enrollment system.

What insurance does Robert De Wall accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Robert De Wall as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Robert De Wall was last updated on October 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.