DEBBIE R. TIDWELL (NPI# 1780703819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780703819 |
| Entity Type | Individual |
| Full Name | DEBBIE R. TIDWELL |
| Credential | LSW |
| Practice Address |
2055 Garrett Way Suite 1 Pocatello ID 83201-5100 |
| Mailing Address |
Po Box 4908 Pocatello ID 83205-4908 |
| Practice Telephone | 2082337832 |
| Mailing Telephone | 2082361600 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LSW-27344 | ID | Behavioral Health & Social Service Providers |
| Street Address |
2055 GARRETT WAY SUITE 1 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174629976 | Portneuf Valley Family Center | Counselor | 2055 Garrett Way, Suite 1, Pocatello, ID 83201-5100 | 2006-09-16 |
| 1326498981 | Idaho Transportation Company, Inc | Non-emergency Medical Transport (VAN) | 2055 Garrett Way, Pocatello, ID 83201-5100 | 2016-06-14 |
| 1003178559 | Courtney Moore | Counselor | 2055 Garrett Way, Ste 2, Pocatello, ID 83201-5100 | 2012-06-11 |
| 1225304074 | Trevor Sparrow | Counselor | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 | 2012-03-27 |
| 1396011284 | Mandy Tate | Counselor | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 | 2012-03-26 |
| 1285900183 | Brett Sayer | Counselor | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 | 2012-03-26 |
| 1841565199 | Joann S Martinez | Social Worker | 2055 Garrett Way, Pocatello, ID 83201-5100 | 2012-03-20 |
| 1285907154 | Kerry Olson | Counselor | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 | 2012-02-22 |
| 1043580855 | Darci J Kearn | Counselor | 2055 Garrett Way, Ste 2, Pocatello, ID 83201-5100 | 2012-01-10 |
| 1669742524 | Larry Lisonbee | Counselor | 2055 Garrett Way, Ste 2, Pocatello, ID 83201-5100 | 2012-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588202907 | Brianna Dannielle Windhorst | Counselor | 611 Wilson Ave Ste 5, Pocatello, ID 83201-5046 | 2019-12-16 |
| 1417598384 | Barton Vandenburg | Counselor | 1001 N 7th Ave, Pocatello, ID 83201-5761 | 2019-10-02 |
| 1689163867 | Sarah Nicolle Baquet | Counselor | 224 S Arthur Ave # 2, Pocatello, ID 83204-3202 | 2018-05-03 |
| 1750803110 | David Tim Williams | Counselor | 224 S. Arthur Suite 2, Pocatello, ID 83204 | 2017-07-07 |
| 1730437500 | Jeremy Garth Coleman | Counselor | 1246 Yellowstone Ave Ste F, Pocatello, ID 83201-4374 | 2012-08-27 |
| 1255602983 | Covey LLC | Counselor | 730 E Clark St # 4571, Pocatello, ID 83201-6238 | 2012-01-26 |
| 1427337831 | Justice Isaacson | Counselor | Cognitive Restructuring LLC, 707 North 7th Ave Ste #d, Pocatello, ID 83201-3357 | 2011-08-16 |
| 1700165628 | Connie Kreizenbeck | Counselor | 409 Washington Ave., Pocatello, ID 83201 | 2011-08-09 |
| 1740568658 | Kimberly B Rasmussen | Counselor | 231 N 6th, Pocatello, ID 83201 | 2011-07-26 |
| 1699005132 | Gina H Judd | Counselor | 819 N 12th Ave, Pocatello, ID 83201-4741 | 2010-01-06 |
| Find all providers in POCATELLO | ||||
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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.