IDAHO DEPARTMENT OF HEALTH & WELFARE REGION 7 AMH CLINIC IF (NPI# 1558497966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558497966 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPARTMENT OF HEALTH & WELFARE REGION 7 AMH CLINIC 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 | 2007-02-27 |
| 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 | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD | 000010019677 | 01 | |
| ID | 8061288 | 05 | |
| BLUE CROSS OF IDAHO | HW181 | 01 |
| Street Address |
150 SHOUP AVE SUITE 17 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275669152 | Idaho Dept of Health & Welfare Region 7 Amh Psr If | Clinic/Center | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2007-02-26 |
| 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 |
| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164781365 | Latino Stand Up | Clinic/Center | 1420 E 17th St Ste E, Idaho Falls, ID 83404-6283 | 2012-05-08 |
| 1184022493 | Sarah Hernandez | Clinic/Center | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2014-12-18 |
| 1043556608 | Latino Stand Up Idaho LLC | Clinic/Center | 1680 Woodruff Park, Idaho Falls, ID 83401-3330 | 2012-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808019 | Helping Hearts Counseling Center, Pllc | Clinic/Center | 310 Cleveland Blvd, Caldwell, ID 83605-3624 | 2020-10-12 |
| 1811502438 | Dale Wilson Counseling and Evaluation | Clinic/Center | 6126 W State St Ste 101, Boise, ID 83703-2741 | 2020-09-10 |
| 1144843285 | Whole Health Counseling LLC | Clinic/Center | 2616 W Jefferson St, Boise, ID 83702-4713 | 2020-05-23 |
| 1033740865 | Jackie Nelson, Pllc | Clinic/Center | 202 N 9th St Ste 401c, Boise, ID 83702-5770 | 2020-01-30 |
| 1437621646 | Joanne Burgio Phd LLC | Clinic/Center | 3061 S Meridian Rd Ste 150, Meridian, ID 83642-7962 | 2018-12-28 |
| 1700394822 | Lookout Behavioral Health LLC | Clinic/Center | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2018-01-11 |
| 1346759495 | Pacific Mind Institute | Clinic/Center | 2596 N Stokesberry Pl Ste 165, Meridian, ID 83646-6281 | 2017-09-20 |
| 1336599976 | Easy Go Express | Clinic/Center | 3551 W Antelope Rd, Moore, ID 83255-8754 | 2016-06-14 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1447695630 | Susan M. Beglinger, Ltd | Clinic/Center | 206 E Indiana Ave, Suite 112, Coeur D Alene, ID 83814-2969 | 2013-05-01 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on IDAHO DEPARTMENT OF HEALTH & WELFARE REGION 7 AMH CLINIC 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.