STATE OF MIND COUNSELING AND WELLNESS CENTER (NPI# 1013277128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013277128 |
| Entity Type | Organization |
| Organization Name | STATE OF MIND COUNSELING AND WELLNESS CENTER |
| Practice Address |
141 N Palmetto Ave Unit 1626 Eagle ID 83616-8066 |
| Mailing Address |
233 W State St Ste D Eagle ID 83616-4982 |
| Practice Telephone | 2089393999 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-07-27 |
| Authorized Official Name | LYNDA SMITH (LPC) |
| Authorized Official Telephone | 2086022293 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 4841 | ID | Agencies |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
4841 | ID | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
4841 | ID | Ambulatory Health Care Facilities |
| Street Address |
141 N PALMETTO AVE UNIT 1626 |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-8066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508405945 | Nate Bonovitz Counseling, LLC | Clinic/Center | 1151 E Iron Eagle Dr, Eagle, ID 83616-6854 | 2020-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620750 | Jim Smidt | Clinic/Center | 820 N William St, Post Falls, ID 83854-5123 | 2019-10-10 |
| 1225507668 | Summus Counseling, LLC | Clinic/Center | 211 S Woodruff Ave Ste 13, Idaho Falls, ID 83401-4324 | 2018-11-14 |
| 1750705687 | Answers, LLC | Clinic/Center | 527 W 20th St, Idaho Falls, ID 83402-4421 | 2014-02-12 |
| 1124372370 | A Plus Solutions Center | Clinic/Center | 2311 Parke Ave. Unit 3, Suite 12, Burley, ID 83318 | 2012-11-08 |
| 1598012700 | Tueller Counseling Services | Clinic/Center | 2275 West Broadway Suite G, Idaho Falls, ID 83402 | 2012-08-07 |
| 1952674988 | My Brother's Keeper Mbk | Clinic/Center | 704 S Cole Rd, Boise, ID 83709-1861 | 2012-02-22 |
| 1639476294 | Idaho Dept of Health & Welfare Reg 2 Cmh | Clinic/Center | 1350 Troy Highway, Moscow, ID 83843-3995 | 2011-02-17 |
| 1154639714 | Eartherapy | Clinic/Center | 354 W Sunnyside Rd, Suite D, Idaho Falls, ID 83402-4644 | 2010-09-16 |
| 1104048503 | Community Partnerships of Idaho, Inc. | Clinic/Center | 3214 N Acre Ln, Boise, ID 83704-4501 | 2007-05-03 |
| 1265654461 | About Balance Mental Health LLC | Clinic/Center | 6550 Emerald St, Suite 112, Boise, ID 83704 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
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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.