LISA MICHELLE KOLLER SUDA
NPI 1467221093
Counselor - Addiction (Substance Use Disorder) in Idaho Falls, ID

Q: What is Lisa Koller's NPI number?

The NPI number for Lisa Koller is 1467221093. It was assigned to this individual provider in the NPPES registry on December 22, 2023.

Q: What is Lisa Koller's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Koller was last updated on December 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since December 22, 2023

1810 W BROADWAY ST, IDAHO FALLS, ID 83402(208) 313-4550 Get Directions Write a Review

NPPES record last updated: December 22, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lisa Michelle Koller Suda NPPES

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

LISA MICHELLE KOLLER SUDA (NPI 1467221093) is an individual addiction (substance use disorder) provider in Idaho Falls, Idaho, licensed in Idaho (13020) and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1467221093

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameLISA MICHELLE KOLLERCredential: SUDA

Location Address1810 W BROADWAY STIdaho Falls, ID 83402-5072

Mailing Address1422 Fremont AveIdaho Falls, ID 83402-1553 · (208) 313-4550

Phone(208) 313-4550

Sole ProprietorYes

Enumeration DateDecember 22, 2023

NPPES CertifiedDecember 22, 2023

✔ NPI 1467221093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in ID · 13020

1810 W BROADWAY ST, Idaho Falls, ID 83402

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Other Providers at the Same Location NPPES 3

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

DYLAN MARSHALL LANDEEN LCSW

Social Worker (Clinical)

1810 W BROADWAY ST
IDAHO FALLS, ID 83402

Bonneville County (208) 206-7613

TINA RENEE CLEVERLEY LMSW

Social Worker

1810 W BROADWAY ST
IDAHO FALLS, ID 83402

Bonneville County (208) 552-7011

MR. JONATHAN RILEY MURDOCK LCSW

Social Worker (Clinical)

1810 W BROADWAY ST
IDAHO FALLS, ID 83402

Bonneville County (208) 538-3122

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 Lisa Koller's NPI number?

The NPI number for Lisa Koller is 1467221093. It was assigned to this individual provider in the NPPES registry on December 22, 2023.

Where is Lisa Koller located?

Lisa Koller practices at 1810 W Broadway St, Idaho Falls, ID 83402. The listed phone number is (208) 313-4550.

What is Lisa Koller's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Lisa Koller was last updated on December 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.