Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Robert Andrew De Wall, LCPC

Individual provider Professional Counselor · NPI 1114228384

Robert Andrew De Wall, LCPC is a Mental Health Counselor in Pocatello, Idaho. Qualified in 2008, 18 years ago. Practices with Portneuf Valley Family Center, an 8-clinician group and offers telehealth. Licensed in Idaho.

Years since qualifying
18
Licensed in
ID
In the registry since
2010
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

444 Hospital Way Ste 477
Pocatello, ID 83201-2744
Phone: (208) 233-7832
Fax: (208) 233-7835
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LCPC-4672 (ID)

Record details

NPI number1114228384
Entity typeIndividual (Type 1)
GenderMale
Credentials LCPC
Sole proprietorYes
NPI enumeratedNovember 4, 2010
Last updated in NPPESOctober 22, 2021
Certification dateOctober 22, 2021
Mailing address65 Fordham St, Pocatello, ID 83201-3418

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Portneuf Valley Family Center — 8 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

Other providers in Pocatello