EMILY DIANE BERGSTROM (NPI# 1184254146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184254146 |
| Entity Type | Individual |
| Full Name | EMILY DIANE BERGSTROM |
| Credential | LPC |
| Practice Address |
2365 N 34th St Boise ID 83703-5523 |
| Practice Telephone | 2084738205 |
| Mailing Telephone | 2084738205 |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2020-01-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC-6167 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154177 | Emily Victoria Bergstrom | Student in an Organized Health Care Education/Training Program | Baylor Scott & White Clinic, 425 University Blvd., Suite 345, Round Rock, TX 78665 | 2019-03-22 |
| 1255810669 | Emily Bergstrom | Counselor | 1145 Sagamore Ave, Portsmouth, NH 03801 | 2018-08-08 |
| Street Address |
2365 N 34TH ST |
| City | BOISE |
| State | ID |
| Zip Code | 83703-5523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003425547 | Jennifer Weseman | Counselor | 6305 W Overland Rd Ste 100, Boise, ID 83709-3029 | 2020-07-30 |
| 1801405766 | Kristin Sue Richards | Counselor | 2000 N Larch St, Boise, ID 83706-1020 | 2020-07-27 |
| 1891316972 | Mary Lott | Counselor | 6300 W Denton St, Boise, ID 83704-9326 | 2020-04-30 |
| 1750900429 | Patrick Barga | Counselor | 344 S Latah St Apt 202, Boise, ID 83705-5175 | 2020-04-13 |
| 1073150033 | Allegiance Behavioral Health LLC | Counselor | 1010 N Orchard St Ste 1a, Boise, ID 83706-2255 | 2019-12-09 |
| 1841836178 | Hopeful Connections Parenting, LLC | Counselor | 1027 S Curtis Rd, Boise, ID 83705-1842 | 2019-11-21 |
| 1528601440 | Idaho Federtion of Families | Counselor | 704 N 7th St, Boise, ID 83702-5503 | 2019-10-23 |
| 1073154175 | A Better Life Counseling Pllc | Counselor | 4948 W Kootenai St Ste 102, Boise, ID 83705-2081 | 2019-10-01 |
| 1265087522 | Rosalie Lacivita | Counselor | 921 S Orchard St Ste 100, Boise, ID 83705-1916 | 2019-08-05 |
| 1184277618 | Ann Marie Clayton | Counselor | 7811 W Ustick Rd Apt 101, Boise, ID 83704-5890 | 2019-07-23 |
| Find all providers in BOISE | ||||
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| 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.