AMY HERZOG (NPI# 1861534133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861534133 |
Entity Type | Individual |
Full Name | AMY HERZOG |
Credential | LCSW |
Practice Address |
175 Brome Dr. #7 Victor ID 83455 |
Mailing Address |
175 Brome Dr. 7 Victor ID 83455 |
Practice Telephone | 4063601631 |
Mailing Telephone | 4063601631 |
Enumeration Date | 2007-02-13 |
Last Update Date | 2009-10-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101Y00000X | Counselor | WY | Behavioral Health & Social Service Providers | |
Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467856013 | Amy Herzog | Dental Assistant | 12711 Se Mill Plain Blvd, Vancouver, WA 98684-6053 | 2014-10-10 |
Street Address |
175 BROME DR. #7 |
City | VICTOR |
State | ID |
Zip Code | 83455 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376050385 | Hunters Inc | Pharmacy | 81 N. Main St., Victor, ID 83455 | 2017-12-29 |
1194109306 | Emily Williams | Occupational Therapist | 73 N Main Street, Victor, ID 83455 | 2015-07-17 |
1073918173 | Teton Valley Vision PC | Optometrist | 7389 S Hwy 33, Ste B, Victor, ID 83455 | 2014-10-31 |
1437440591 | Nathan Richard George | Dentist | 7726 Lupine Lane, Victor, ID 83455 | 2011-04-25 |
1245537695 | Erin N Borbet | Acupuncturist | 108 W Center St Unit 3, Victor, ID 83455 | 2011-02-22 |
1336457837 | Grand Teton Dental Care | Clinic/Center | 741 South 50 West, Suite A, Victor, ID 83455 | 2010-09-17 |
1598086126 | Childs Play, LLC | Speech-Language Pathologist | 73 North Main, Victor, ID 83455 | 2010-06-17 |
1891025656 | Phillips Therapy Incorporated | Occupational Therapist | 73 North Main St., Suite 3, Victor, ID 83455 | 2009-12-30 |
1861621278 | Elmer Raymond Cherry Iv | Dentist | 7389 S. Hwy. 33 Suite A, Victor, ID 83455 | 2009-07-07 |
1902978323 | James K Davis | Chiropractor | 164 North Main Street, Victor, ID 83455 | 2006-11-14 |
Find all providers in zip 83455 |
Taxonomy Code | 251C00000X |
Grouping | Agencies |
Classification | Day Training, Developmentally Disabled Services |
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902205230 | Andrea Loban | Day Training, Developmentally Disabled Services | 5049 Fox Creek Hollow, Victor, ID 83455-0000 | 2014-08-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477086114 | Teton Supported Living LLC | Day Training, Developmentally Disabled Services | 4101 N Creswell Way, Boise, ID 83713-2404 | 2017-04-10 |
1962889055 | Community Connections South Central | Day Training, Developmentally Disabled Services | 212 2nd Ave W, #102 & 104, Twin Falls, ID 83301-6016 | 2015-04-28 |
1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
1336570118 | Independent Living Specialists, LLC | Day Training, Developmentally Disabled Services | 379 Yellowstone Ave, Pocatello, ID 83201-4529 | 2013-12-04 |
1871935064 | Community Connections North, Inc. | Day Training, Developmentally Disabled Services | 1230 N Northwood Center Ct, Suite A, Coeur D Alene, ID 83814-4941 | 2013-07-29 |
1851734107 | Foundations for Independence LLC | Day Training, Developmentally Disabled Services | 2316 N Cole Rd Ste C, Boise, ID 83704-7365 | 2013-04-16 |
1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
1457694176 | A Plus Solutions Center | Day Training, Developmentally Disabled Services | 2311 Park Ave, Unit 3, Suite 12, Burley, ID 83318-2104 | 2013-04-01 |
1518208966 | Learning Garden Developmental Preschool | Day Training, Developmentally Disabled Services | 412 E Mullan Ave, Post Falls, ID 83854-7641 | 2013-03-11 |
1831442805 | A Plus Solutions Developmental Center LLC | Day Training, Developmentally Disabled Services | 2251 Overland Avenue, Suite Number 5, Burley, ID 83318 | 2012-10-16 |
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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.