MICHAEL EDWARDS M.A., LCPC, LAC
NPI 1376664359
Counselor - Mental Health in Whitefish, MT
NPI Status: Active since April 03, 2007
Contact Information
2004 HOSPITAL WAY
WHITEFISH, MT
ZIP 59937
Phone: (406) 862-1030
- Individual
- Male
- Years of Experience 20
- Counselor
- Mental Health
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL EDWARDS
This page provides the complete NPI Profile along with additional information for Michael Edwards, a provider established in Whitefish, Montana with a medical specialization in Counselor, focusing in mental health and more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1376664359 assigned on April 2007. The practitioner's primary taxonomy code is 101YM0800X with license number 736 (NH). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1376664359
- Provider Name
- MICHAEL EDWARDS M.A., LCPC, LAC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2004 HOSPITAL WAY WHITEFISH, MT 59937
- Location Phone
- (406) 862-1030
- Mailing Address
- 2004 HOSPITAL WAY WHITEFISH, MT 59937
- Mailing Phone
- (406) 862-1030
- Medical School Name
- OTHER
- Graduation Year
- 2006
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-03-2007
- Last Update Date
- 02-05-2016
- Code Navigator
A mental health counselor like Michael Edwards provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Mental Health
- Taxonomy Code
- 101YM0800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 736
- License State
- NH
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | BBH-LAC-LIC-13219 (MT) |
| 2 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | 650 (NH) |
| 3 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | BBH-LCPC-LIC-13148 (MT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? 902 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? 903 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Peak PPO Bronze HDHP - PPO
- Peak PPO Bronze Standard - PPO
- Peak PPO Catastrophic - PPO
- Peak PPO Gold - PPO
- Peak PPO Gold Standard - PPO
- Peak PPO Silver - PPO
- Peak PPO Silver Standard - PPO
- Plus Bronze - PPO
- Plus Bronze Standard - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- PEAK PPO BRONZE - PPO
- PEAK PPO BRONZE HDHP - PPO
- PEAK PPO GOLD - PPO
- PEAK PPO GOLD HDHP - PPO
- PEAK PPO SILVER - PPO
- PEAK PPO SILVER HDHP - PPO
- Plus Bronze HDHP - PPO
- Plus Gold HDHP - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 77066380NH01 | OTHER (01) | ANTHEM |
Medicare Participation & PECOS Enrollment Status
Michael Edwards is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Edwards is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4385089580
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240227004167
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michael Edwards is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| LOGAN HEALTH - WHITEFISH | 1600 HOSPITAL WAY WHITEFISH, MT 59937 | (406) 863-3550 | Critical Access Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1376664359, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
WHITEFISH, MT 59937
WHITEFISH, MT 59937
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376664359, enumerated as an "individual" on April 03, 2007.
The provider is located at 2004 HOSPITAL WAY WHITEFISH, MT 59937 and the phone number is (406) 862-1030.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Mountain. Please consult your insurance carrier or call the provider to verify.
Michael Edwards is affiliated with: LOGAN HEALTH - WHITEFISH.
