DR. POLLY A PETERSON (NPI# 1740340678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740340678 |
| Entity Type | Individual |
| Full Name | DR. POLLY A PETERSON |
| Credential | PH.D. |
| Practice Address |
1406 E Franklin St Boise ID 83712-7404 |
| Practice Telephone | 2083311936 |
| Practice Fax Number | 2083311937 |
| Mailing Telephone | 2083311936 |
| Mailing Fax Number | 2083311937 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
COUN-50 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316324700 | Polly Peterson | Psychologist | 125 W Granite St Ste 212, Butte, MT 59701-9215 | 2015-05-05 |
| 1902929698 | Polly Wietzke Peterson | Psychologist | 1555 Kingsley Ave, Orange Park, FL 32073-9201 | 2007-04-09 |
| Street Address |
1406 E FRANKLIN ST |
| City | BOISE |
| State | ID |
| Zip Code | 83712-7404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003425547 | Jennifer Weseman | Counselor | 6305 W Overland Rd Ste 100, Boise, ID 83709-3029 | 2020-07-30 |
| 1801405766 | Kristin Sue Richards | Counselor | 2000 N Larch St, Boise, ID 83706-1020 | 2020-07-27 |
| 1891316972 | Mary Lott | Counselor | 6300 W Denton St, Boise, ID 83704-9326 | 2020-04-30 |
| 1750900429 | Patrick Barga | Counselor | 344 S Latah St Apt 202, Boise, ID 83705-5175 | 2020-04-13 |
| 1184254146 | Emily Diane Bergstrom | Counselor | 2365 N 34th St, Boise, ID 83703-5523 | 2020-01-18 |
| 1073150033 | Allegiance Behavioral Health LLC | Counselor | 1010 N Orchard St Ste 1a, Boise, ID 83706-2255 | 2019-12-09 |
| 1841836178 | Hopeful Connections Parenting, LLC | Counselor | 1027 S Curtis Rd, Boise, ID 83705-1842 | 2019-11-21 |
| 1528601440 | Idaho Federtion of Families | Counselor | 704 N 7th St, Boise, ID 83702-5503 | 2019-10-23 |
| 1073154175 | A Better Life Counseling Pllc | Counselor | 4948 W Kootenai St Ste 102, Boise, ID 83705-2081 | 2019-10-01 |
| 1265087522 | Rosalie Lacivita | Counselor | 921 S Orchard St Ste 100, Boise, ID 83705-1916 | 2019-08-05 |
| Find all providers in BOISE | ||||
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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.