MODERN PSYCHOTHERAPY SERVICES (NPI# 1649674888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649674888 |
| Entity Type | Organization |
| Organization Name | MODERN PSYCHOTHERAPY SERVICES |
| Practice Address |
4875 W Athens Ct Eagle ID 83616-5138 |
| Practice Telephone | 2087317646 |
| Mailing Telephone | 2087317646 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |
| Authorized Official Name | DIANA LINCOLN-HAYE (PRESIDENT) |
| Authorized Official Telephone | 2087317646 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC-5605 | ID | Behavioral Health & Social Service Providers |
| Street Address |
4875 W ATHENS CT |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-5138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083016992 | Diana Lincoln-haye | Counselor | 4875 W Athens Ct, Eagle, ID 83616-5138 | 2014-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356834881 | Patricia Taylor | Counselor | 1046 N Snead Pl, Eagle, ID 83616-6508 | 2018-06-09 |
| 1619323649 | Joshua Bynum | Counselor | 651 N Eagle Rd, Eagle, ID 83616-5007 | 2016-05-09 |
| 1811265325 | Lynda Smith | Counselor | 316 E Kite Dr, Eagle, ID 83616-5378 | 2011-12-12 |
| 1801034715 | Jon Robert Worbets | Counselor | 216 N Storybook Way, Eagle, ID 83616 | 2009-01-30 |
| 1306018049 | Audra Jean Bryant | Counselor | 228 E Plaza St Ste B, Pmb#137, Eagle, ID 83616-5982 | 2008-04-01 |
| 1881870095 | Michele Harris | Counselor | 927 W Cherry Bello Dr, Eagle, ID 83616-6980 | 2008-01-17 |
| 1972510063 | Elizabeth Ann Giles-ihling | Counselor | 136 S Academy Ave Ste C, Eagle, ID 83616-6541 | 2006-08-02 |
| 1922504638 | Sage Counseling and Hypnotherapy, LLC | Counselor | 651 N Eagle Rd, Eagle, ID 83616-5007 | 2018-04-02 |
| 1427473594 | Shaunna Bach | Counselor | 4060 E Chinden Blvd, Eagle, ID 83616-6481 | 2014-02-26 |
| 1912335506 | Lynette Fogg | Counselor | 1191 E Iron Eagle Dr, Suite 200, Eagle, ID 83616-5148 | 2013-10-17 |
| Find all providers in EAGLE | ||||
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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.