CRAIG W. BEAVER (NPI# 1225176498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225176498 |
Entity Type | Individual |
Full Name | CRAIG W. BEAVER |
Credential | PH.D. |
Practice Address |
250 Bobwhite Ct Ste 220 Boise ID 83706-3983 |
Practice Telephone | 2083362972 |
Practice Fax Number | 2083364408 |
Mailing Telephone | 2083362972 |
Mailing Fax Number | 2083364408 |
Enumeration Date | 2007-02-01 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | PSY-173 | ID | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | BLUE SHIELD | 000010016209 | 01 |
ID | BLUE CROSS | N1730 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124183389 | Craig Stephen Beaver | Chiropractor | 1937 N Military Trl, Suite D, West Palm Beach, FL 33409-4762 | 2006-12-27 |
Street Address |
250 BOBWHITE CT STE 220 |
City | BOISE |
State | ID |
Zip Code | 83706-3983 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
Find all providers in zip 83706 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295954485 | Saint Alphonsus Regional Medical Center Inc | Clinical Neuropsychologist | 717 N Liberty St, Boise, ID 83704-9342 | 2007-04-25 |
1952443640 | Christine Pickford | Clinical Neuropsychologist | 1104 N 18th St, Boise, ID 83702-3321 | 2007-02-12 |
1326008053 | David E Nilsson | Clinical Neuropsychologist | 2537 W. State St., Suite 210, Boise, ID 83702 | 2006-03-25 |
1790241404 | Boise Brain Health | Clinical Neuropsychologist | 4696 W Overland Rd Ste 228, Boise, ID 83705-2864 | 2019-02-18 |
1215305263 | Cynthia Tremblay | Clinical Neuropsychologist | 600 N Robbins Rd, Boise, ID 83702-4565 | 2015-09-08 |
1154665123 | Merry Sylvester | Clinical Neuropsychologist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2012-11-15 |
1659631562 | Brienne M Dyer | Clinical Neuropsychologist | 500 W Fort St, (b114), Boise, ID 83702-4501 | 2012-05-24 |
1275891194 | David E. Nilsson, Ph.d., P.C. | Clinical Neuropsychologist | 950 W Bannock St Ste 1100, Boise, ID 83702-6140 | 2012-04-28 |
1316241417 | Jeff Alan Sordahl Jr. | Clinical Neuropsychologist | 500 W Fort St, Boise, ID 83702-4501 | 2011-01-04 |
1265677298 | Amy E. Latta, Ph.d., P.a. | Clinical Neuropsychologist | 1020 W Main St, Suite 100b, Boise, ID 83702-5789 | 2008-12-04 |
Find all providers in BOISE |
Please comment or provide details below to improve the information on CRAIG W. BEAVER.
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.