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Active NPI 1114228384 Individual Practitioner Male Practitioner

Robert Andrew De Wall , LCPC

Counselor - Professional • Pocatello, ID

Telehealth Available

Professional Overview & Biography Verified Profile Summary

Robert De Wall, LCPC is a certified Counselor - Professional practicing in Pocatello, ID. With approximately 18 years of clinical experience since completing medical education in 2008, Robert De Wall delivers high-quality medical care to the local community at 444 HOSPITAL WAY STE 477.

Robert De Wall is affiliated with Portneuf Valley Family Center and does not directly accept Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

444 Hospital Way Ste 477

Pocatello, ID 832012744

Telephone 2082337832
Fax 2082337835
Associated Practice Facility / Clinic
🏢 Portneuf Valley Family Center Facility NPI 1174629976

Medicare Profile & Education

Medical School

Other

Graduation Year

2008

Medicare Assignment

Not Specified

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Pocatello, ID

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
18 Yrs -3.5 yrs vs City Avg
City Avg: 21.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
61 Specialists

Practicing in Pocatello, ID (1223 Statewide)

Telehealth Adoption Rate
3.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. De Wall (18 Years) 18 Yrs
Pocatello Specialty Average (21.5 Years) 21.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2021-10-22
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License ID LCPC-4672

Definition to come...

Hospital & Practice Group Affiliations

Portneuf Valley Family Center

444 Hospital Way, Pocatello, ID 832012744

Phone: 2082337832

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Courtney Moore

Counselor - Mental Health

NPI 1003178559
Steven Peters

Counselor

NPI 1013287879
Sherry Deiter

Counselor - Mental Health

NPI 1023390424
Darci Kearn

Counselor

NPI 1043580855
Amber Malay , BS

Case Manager/Care Coordinator

NPI 1043783368

Bachelor of Science

NPI 1093835753

Bachelor of Arts

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 01, 2019

Registered at 444 HOSPITAL WAY STE 477, POCATELLO, ID 832012744 (Tel: 2082337832)

👤
Provider Name / Credentials Updated August 01, 2019

Recorded as ROBERT DE WALL, LCPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2019

Counselor (License #LCPC-4672 in ID)

NPI Profile Active November 04, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location November 04, 2010

Registered at 210 E CENTER ST, SUITE B, POCATELLO, ID 832016326 (Tel: 2082342600)

📍
Updated Business Mailing Address November 04, 2010

Registered at 65 FORDHAM ST, POCATELLO, ID 832013418 (Tel: 2083170027)

👤
Provider Name / Credentials Updated November 04, 2010

Recorded as ROBERT DE WALL, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 04, 2010

Counselor (License #LPC-4188 in ID)

🟢
Initial NPI Registration & Enumeration November 04, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114228384
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 04, 2010
Last Update: October 22, 2021
Sole Proprietor: Yes

Mailing Address

65 Fordham St

Pocatello, ID 832013418

Phone: 2083170027

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.