GARY SEAN REDFORD (NPI# 1962804757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962804757 |
| Entity Type | Individual |
| Full Name | GARY SEAN REDFORD |
| Credential | LPC, NCC |
| Practice Address |
12930 N Rio Vista Rd Pocatello ID 83202-5007 |
| Practice Telephone | 2082266059 |
| Mailing Telephone | 2082266059 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC-5620 | ID | Behavioral Health & Social Service Providers |
| Street Address |
12930 N RIO VISTA RD |
| City | POCATELLO |
| State | ID |
| Zip Code | 83202-5007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1649712597 | Angie M Mccurdy | Audiologist | 4155 Yellowstone Hwy, Pine Ridge Mall, Pocatello, ID 83202 | 2016-11-09 |
| 1285180836 | Beverly Grigg Jones | Counselor | 210 W. Burnside, Chubbuck, ID 83202 | 2016-09-01 |
| 1376992503 | Andrea Walsh | Nurse Practitioner | 1133 Call Creek Dr, Ste A, Pocatello, ID 83202 | 2016-06-08 |
| 1215381181 | Specialized Physical Therapy Pllc | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202 | 2016-04-18 |
| 1457713588 | Jennifer Ann Gould | Radiologic Technologist | 907 Ryan Street, Chubbuck, ID 83202 | 2016-03-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1750781449 | Jennifer Lynn Seaich | Counselor | 4460 Center Way, Center Counseling, Pocatello, ID 83202 | 2014-08-29 |
| 1336562412 | Kurt Layton | Counselor | 337 Joel, Chubbuck, ID 83202 | 2014-01-27 |
| 1245653468 | Hannah's Place LLC | Occupational Therapist | 240 W Burnside Ave Ste D, Chubbuck, ID 83202 | 2014-01-23 |
| Find all providers in zip 83202 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669081311 | Catherine Leavitt | Counselor | 921 S 8th Ave # 8136, Pocatello, ID 83209-0002 | 2020-07-29 |
| 1407363690 | Kimberly B Rasmussen, Pllc | Counselor | 850 E Center St Ste F, Pocatello, ID 83201-5737 | 2018-01-09 |
| 1508396714 | Steven Richard Miner | Counselor | 440 E Clark St Ste A, Pocatello, ID 83201-6308 | 2017-06-20 |
| 1306210398 | Amanda Bland | Counselor | 1133 Rowland Rd, Pocatello, ID 83204-7416 | 2015-11-14 |
| 1750781449 | Jennifer Lynn Seaich | Counselor | 4460 Center Way, Center Counseling, Pocatello, ID 83202 | 2014-08-29 |
| 1437585189 | Shayla F Ward | Counselor | 459 S Arthur Ave, Pocatello, ID 83204-3303 | 2013-09-25 |
| 1366781262 | Gail Taylor Thorngren | Counselor | 201 E Center St Ste B, Pocatello, ID 83201-6339 | 2013-02-12 |
| 1851650691 | Christine Collaer-muzzo | Counselor | 120 S 12th Ave Ste 4, Pocatello, ID 83201-4814 | 2012-05-14 |
| 1164780706 | Kimberly Jo Andrew | Counselor | 421 E Oak St, Pocatello, ID 83201-4601 | 2012-05-02 |
| 1114228384 | Robert Andrew De Wall | Counselor | 444 Hospital Way Ste 477, Pocatello, ID 83201-2744 | 2010-11-04 |
| 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.