DR. JACK D NEWSOME (NPI# 1124169354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124169354 |
| Entity Type | Individual |
| Full Name | DR. JACK D NEWSOME |
| Credential | PH.D LCPC |
| Practice Address |
732 Washington Ave Pocatello ID 83201-3748 |
| Mailing Address |
944 Dixon Idaho Falls ID 83401 |
| Practice Telephone | 2084789822 |
| Practice Fax Number | 2084786790 |
| Mailing Telephone | 2084789822 |
| Mailing Fax Number | 2084786790 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LCPC 3403 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356384879 | Jack Edward Newsome Jr. | Chiropractor | 21 S Commerce St, Liberty, SC 29657-1132 | 2006-06-13 |
| Street Address |
732 WASHINGTON AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-3748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861544454 | A To Z Family Services, Inc. | Community/Behavioral Health | 732 Washington Ave, Pocatello, ID 83201-3748 | 2007-01-17 |
| 1659799567 | Rocky Mountain Home Health and Hospice | Hospice Care, Community Based | 732 Washington Ave, Pocatello, ID 83201-3748 | 2014-03-29 |
| 1104243021 | Rocky Mountain Home Health and Hospice | Home Health | 732 Washington Ave, Pocatello, ID 83201-3748 | 2014-03-28 |
| 1790028983 | Melissa D. Syria | Counselor | 732 Washington Ave, Pocatello, ID 83201-3748 | 2013-04-05 |
| 1396040036 | Tyrone Richard Shuman | Social Worker | 732 Washington Ave, Pocatello, ID 83201-3748 | 2011-01-11 |
| 1477856847 | Doty Janene Collins | Social Worker | 732 Washington Ave, Pocatello, ID 83201-3748 | 2010-12-07 |
| 1043510613 | Sandra Lyn Vollmer | Counselor | 732 Washington Ave, Pocatello, ID 83201-3748 | 2010-10-28 |
| 1457521114 | Altan C Hardcastle | Social Worker | 732 Washington Ave, Pocatello, ID 83201-3748 | 2008-03-08 |
| 1043438377 | A To Z Family Services Inc. | Community/Behavioral Health | 732 Washington Ave, Pocatello, ID 83201-3748 | 2007-04-23 |
| 1740406586 | A To Z Family Services Inc. | Community/Behavioral Health | 732 Washington Ave, Pocatello, ID 83201-3748 | 2007-04-18 |
| 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.