IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR IF (NPI# 1275669152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275669152 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR IF |
| Practice Address |
150 Shoup Ave Suite 17 Idaho Falls ID 83402-3657 |
| Practice Telephone | 2085285700 |
| Practice Fax Number | 2085285747 |
| Mailing Telephone | 2085285700 |
| Mailing Fax Number | 2085285747 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MELISSA M BEAN (PROGRAM MANAGER) |
| Authorized Official Telephone | 2085285706 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD | 000010019479 | 01 | |
| BLUE CROSS OF IDAHO | HW181 | 01 | |
| ID | 0028410 | 05 |
| Street Address |
150 SHOUP AVE SUITE 17 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639733256 | Michaelina S Page | Registered Nurse | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2019-04-29 |
| 1013489285 | Maria Rodriguez-moncada | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-12-27 |
| 1437626124 | Elizabeth Rae Lagazo | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-10-31 |
| 1942784756 | Robert Creighton Shumway | Physician Assistant | 150 Shoup Ave, #170, Idaho Falls, ID 83402 | 2018-09-18 |
| 1023507977 | Zachary Wixom | Counselor | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-05-07 |
| 1841723822 | Jennifer Lebel | Registered Nurse | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2017-04-06 |
| 1194264127 | Timothy Mchugh | Physician Assistant | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2017-02-23 |
| 1740730811 | Nichole Chauntelle Wilson | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-10-12 |
| 1700331279 | Kayla Schroeder | Speech-Language Pathologist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-08-24 |
| 1306296488 | Marie Sheranian | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273637 | Answers, LLC - Cbrs | Clinic/Center | 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 | 2020-04-08 |
| 1649808767 | Psychological Preventative Health Pllc | Clinic/Center | 4831 Greystone Ln, Idaho Falls, ID 83404-8338 | 2020-04-01 |
| 1629615406 | Building A Life Worth Living, LLC | Clinic/Center | 771 S Woodruff Ave, Idaho Falls, ID 83401-5286 | 2019-11-29 |
| 1053732263 | A To Z Family Services | Clinic/Center | 380 N Capital Ave, Idaho Falls, ID 83402-3633 | 2013-12-16 |
| 1063760452 | Esperanza Mental Health | Clinic/Center | 692 Evans Dr, Idaho Falls, ID 83402-5026 | 2012-08-16 |
| 1508124967 | Starr and Cody Counseling, LLC | Clinic/Center | 1820 E 17th St Ste 230, Idaho Falls, ID 83404-6521 | 2012-04-23 |
| 1861765620 | Lean On Me, Inc. | Clinic/Center | 150 N Woodruff Ave, Idaho Falls, ID 83401-4335 | 2012-02-09 |
| 1235352675 | Access Point Family Services Inc. | Clinic/Center | 2680 Channing Way, Idaho Falls, ID 83404-7517 | 2007-04-11 |
| 1477172435 | Answers, LLC - Case Management | Clinic/Center | 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 | 2020-04-10 |
| 1386263341 | Answers LLC - Peer Support | Clinic/Center | 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 | 2020-04-10 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on IDAHO DEPT OF HEALTH & WELFARE REGION 7 AMH PSR IF.
| 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.