P Praxis·MD
● Active Type 1 · Individual

Robert Andrew De Wall, LCPC

Counselor·Pocatello, ID· NPI 1114228384 · Enumerated 2010 · 15 years on NPI
De Wall is 1 of 67 counselor providers in Pocatello and 1 of 1313 in Idaho.
NPI age
15 years
Enumerated 2010-11-04
Primary specialty
Counselor
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-10-22
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 1313 active counselor providers in Idaho.

NPI age
15 years
↑ 6 yr above median (9 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
24% of peers hold subspecialties

NPI lifetime · 2010 → 2026

2010-11Enumerated in NPPES
2010 2026

Where they practice

Practice location
444 Hospital Way Ste 477
Pocatello, ID 832012744
📞 2082337832fax 2082337835
Mailing address
65 Fordham St
Pocatello, ID 832013418
📞 2083170027fax 2082342800

Specialties

  • Counselor Primary
    Definition to come...
    ID license #LCPC-4672 taxonomy 101YP2500X

Practice context

Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.

Recently enumerated nearby: 2 new counselor providers have been added in Pocatello in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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