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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YS0200X |
Counselor Specialization: School |
LPC-7837 | ID | Behavioral Health & Social Service Providers |
Street Address |
707 W WYETH ST |
City | POCATELLO |
State | ID |
Zip Code | 83204-3058 |
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 Code | 101YS0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | School |
Definition to come... |
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 |
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 |
Please comment or provide details below to improve the information on JO ANNA SHOTIVEYARATANA.
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.