PSYCHOLOGICAL PREVENTATIVE HEALTH PLLC


Address: 4831 Greystone Ln, Idaho Falls, ID 83404-8338
Phone: 2087093925

PSYCHOLOGICAL PREVENTATIVE HEALTH PLLC (NPI# 1649808767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649808767
Entity Type Organization
Organization Name PSYCHOLOGICAL PREVENTATIVE HEALTH PLLC
Practice Address 4831 Greystone Ln
Idaho Falls
ID 83404-8338
Mailing Address 2184 Channing Way # 157
Idaho Falls
ID 83404-8034
Practice Telephone 2087093925
Practice Fax Number 8888879784
Mailing Telephone 2087093925
Mailing Fax Number 8888879784
Enumeration Date 2020-04-01
Last Update Date 2020-04-01
Authorized Official Name MELANIE FOWERS (OWNER)
Authorized Official Telephone 2087093925
Authorized Official Credential LCSW
Is Organization Subpart N

Taxonomy

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

Office Location

Street Address 4831 GREYSTONE LN
City IDAHO FALLS
State ID
Zip Code 83404-8338

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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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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
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
1477172435 Answers, LLC - Case Management Clinic/Center 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 2020-04-10
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Competitor

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City IDAHO FALLS
Zip Code 83404

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Dataset Information

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.

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