JO ANNA SHOTIVEYARATANA


Address: 707 W Wyeth St, Pocatello, ID 83204-3058
Phone: 2082403799

JO ANNA SHOTIVEYARATANA (NPI# 1104424191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104424191
Entity Type Individual
Full Name JO ANNA SHOTIVEYARATANA
Credential MA, LPC
Practice Address 707 W Wyeth St
Pocatello
ID 83204-3058
Practice Telephone 2082403799
Mailing Telephone 2082403799
Enumeration Date 2020-10-13
Last Update Date 2020-10-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YS0200X Counselor
Specialization: School
LPC-7837 ID Behavioral Health & Social Service Providers

Office Location

Street Address 707 W WYETH ST
City POCATELLO
State ID
Zip Code 83204-3058

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NPI Name Taxonomy Address Enumeration
1568974541 Daniel Graham Rasmussen Social Worker 335 N. Main, Pocatello, ID 83204 2017-10-30
1801311246 Thomas Henrie Specialist/Technologist 3960 Stockman Rd., Pocatello, ID 83204 2017-08-07
1750803110 David Tim Williams Counselor 224 S. Arthur Suite 2, Pocatello, ID 83204 2017-07-07
1023441185 Insight Occupational Therapy, LLC Occupational Therapist 158 N Main St., Pocatello, ID 83204 2013-08-13
1679816912 A New Hope, LLC Day Training, Developmentally Disabled Services 19b Mountain Dr, Pocatello, ID 83204 2013-04-05
1790032431 Wynnona Sarah Warren Pharmacist 911 North Main Street, Pocatello, ID 83204 2012-08-13
1902110380 Belmont Management, Inc. Intermediate Care Facility, Mentally Retarded 6150 S. 5th Ave, Pocatello, ID 83204 2010-07-28
1104066539 Rachel Ann Seibold Speech-Language Pathologist 1254 Swisher Rd, Pocatello, ID 83204 2009-02-25
1710163803 Allen Bennett Martin Clinic/Center 540 South Garfield, Pocatello, ID 83204 2008-01-18
1174711758 Rsm Pa Pllc Physician Assistant 1595 Bannock Hwy, Pocatello, ID 83204 2007-10-09
Find all providers in zip 83204

Taxonomy Information

Taxonomy Code 101YS0200X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization School

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699383737 Health West, Inc. Counselor 1455 Gwen Dr, Pocatello, ID 83204-4860 2020-07-15
1912515057 Health West, Inc. Counselor 666 Cheyenne Ave, Pocatello, ID 83204-3756 2020-07-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1679832596 Jeff Donald Horton Counselor 1204 Tamarack St, Moscow, ID 83843-9438 2012-05-12
1427254671 Minidoka County School District #331 Counselor 310 10th St, Rupert, ID 83350-1421 2007-06-25
1689285595 Cambrea Parker Counselor 1373 Fillmore St, Twin Falls, ID 83301-3392 2020-08-13

Competitor

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City POCATELLO
Zip Code 83204

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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