MR. JESSE RAY COBB (NPI# 1083001630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083001630 |
| Entity Type | Individual |
| Full Name | MR. JESSE RAY COBB |
| Credential | LCSW |
| Practice Address |
1210 Nw 16th St Fruitland ID 83619-2202 |
| Practice Telephone | 2084528600 |
| Mailing Telephone | 2084528600 |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-30921 | ID | Behavioral Health & Social Service Providers |
| Street Address |
1210 NW 16TH ST |
| City | FRUITLAND |
| State | ID |
| Zip Code | 83619-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861483562 | Clinton W Baker | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2005-11-02 |
| 1487290359 | Jared Anthony Bradford | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2019-11-26 |
| 1982074696 | Brett Johansen | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2015-10-07 |
| 1073840278 | Sean W Page | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2009-11-09 |
| 1497998215 | Isaac L Elam | Internal Medicine | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2009-04-08 |
| 1578733234 | Nicole K Hoyt | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2008-03-08 |
| 1073720124 | George J Roth | Physician Assistant | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2007-05-17 |
| 1437240009 | Dwaine Anthony Tesnohlidek | Surgery | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2006-09-27 |
| 1487611877 | Morris H Smith | Emergency Medicine | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2006-04-28 |
| 1205813847 | Roman J Babij | Surgery | 1210 Nw 16th St, Fruitland, ID 83619-2202 | 2005-12-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322382 | Dallin Scott Wilkes | Physical Therapist | 2175 N Whitley Dr., Fruitland, ID 83619 | 2020-07-01 |
| 1659925113 | Treasure Valley Classical Academy | Local Education Agency (LEA) | 500 Sw 3rd Street, Fruitland, ID 83619 | 2019-08-01 |
| 1083146559 | Total Renal Care, Inc. | Clinic/Center | 815 Nw 13th St, Fruitland, ID 83619 | 2017-04-03 |
| 1154563948 | Becky Jean Wolery | Social Worker | 910 Nw 16th St Ste 101, Fruitland, ID 83619 | 2009-03-25 |
| 1740426196 | John Wesley Linhart | Physical Therapist | 1116 Nw 16th Street, Fruitland, ID 83619 | 2009-01-06 |
| 1528263670 | Snake River Dermatology, Pa | Dermatology | 1611 N Whitley Dr, #7, Fruitland, ID 83619 | 2007-06-19 |
| 1568591204 | John Linton Close | Registered Nurse | 1509 N Whitley Drive, Suite 5, Fruitland, ID 83619 | 2007-03-05 |
| 1629110671 | Payette School Dist #373 | Local Education Agency (LEA) | 303 Sw 3rd Street, Fruitland, ID 83619 | 2007-02-13 |
| 1912075839 | William Frederick Martsch | Dentist | 315 N. Whitley, Fruitland, ID 83619 | 2006-11-30 |
| 1992880132 | Ryan David Hillam | Dentist | 1820 N.whitley Drive, Fruitland, ID 83619 | 2006-10-26 |
| Find all providers in zip 83619 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346713401 | Sharon Jones | Social Worker | 532 S Division St, Fruitland, MD 21826-1805 | 2019-01-10 |
| 1669609020 | Frankie Diane Larsen | Social Worker | 7665 Custer Rd, Fruitland, ID 83619-5039 | 2009-06-12 |
| 1003437658 | Larsen Counseling Pllc | Social Worker | 7665 Custer Rd, Fruitland, ID 83619-5039 | 2020-05-05 |
| 1336535178 | Lisa Marie Tovar | Social Worker | 910 Nw 16th St, Fruitland, ID 83619-2265 | 2015-04-08 |
| 1275956880 | Ron Vanausdal | Social Worker | 1611 N Whitley Dr, Fruitland, ID 83619-2177 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171961 | Jill Michelle Chonody | Social Worker | 3134 S Waterbury Ln, Boise, ID 83706-5222 | 2020-10-09 |
| 1750999777 | Deanna Armenia Brent | Social Worker | 7450 W Althea Ct, Boise, ID 83709-1777 | 2020-07-15 |
| 1164040820 | Sylinda Lee Mendenhall | Social Worker | 771 S Jafer Court, Idaho Falls, ID 83401-8404 | 2020-07-09 |
| 1013533231 | Sylvia Oh | Social Worker | 2118 S Latah St, Boise, ID 83705-3947 | 2020-06-23 |
| 1073135851 | Kimberly Ruth Carey | Social Worker | 6160 Dallas Ln, Bonners Ferry, ID 83805-9794 | 2020-05-14 |
| 1497377469 | Raising Resilience Holistic Mental Wellness Inc | Social Worker | 610 W Hubbard St Ste 226, Coeur D Alene, ID 83814-2200 | 2020-05-13 |
| 1417577412 | Stacey Titus Pllc | Social Worker | 5440 W Franklin Rd Ste 201, Boise, ID 83705-6434 | 2020-04-20 |
| 1922627314 | Taresa Dawn Crow | Social Worker | 3655 Samuel St, Ammon, ID 83406-7822 | 2020-04-15 |
| 1447888656 | Berndt and Associates In Psychcare LLC | Social Worker | 4477 W Emerald St Ste C275, Boise, ID 83706-2078 | 2020-04-01 |
| 1467086603 | Abundant Serenity LLC | Social Worker | 925 N Main St Ste A, Meridian, ID 83642-2301 | 2020-02-26 |
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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.