MR. JEREMY WAYNE IRVIN (NPI# 1245684927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245684927 |
| Entity Type | Individual |
| Full Name | MR. JEREMY WAYNE IRVIN |
| Credential | LCSW, MED |
| Practice Address |
1276 W River St Suite 100 Boise ID 83702-7066 |
| Mailing Address |
2020 S Luxury Ln Apt B202 Meridian ID 83642-4274 |
| Practice Telephone | 2083384699 |
| Mailing Telephone | 2087412103 |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-36060 | ID | Behavioral Health & Social Service Providers |
| Street Address |
1276 W RIVER ST SUITE 100 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-7066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679641336 | Amy Lynn Roberts | Counselor | 1276 W River St, Boise, ID 83702-7066 | 2006-12-01 |
| 1962018564 | Access Behavioral Health Services, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1276 W River St, Boise, ID 83702-7066 | 2020-09-18 |
| 1043704414 | Tyler Daniel Lobb | Counselor | 1276 W River St, Boise, ID 83702-7066 | 2018-06-19 |
| 1952752297 | Sara Buffington | Counselor | 1276 W River St, Suite 100, Boise, ID 83702-7066 | 2016-06-28 |
| 1720451230 | Melissa Gryder | Social Worker | 1276 W River St, Boise, ID 83702-7066 | 2015-11-05 |
| 1629458914 | Shell Wamble-fisher | Social Worker | 1276 W River St, Suite 100, Boise, ID 83702-7066 | 2015-06-02 |
| 1205220027 | Gwendolyn Gause | Counselor | 1276 W River St, Ste100, Boise, ID 83702-7066 | 2015-03-19 |
| 1235536558 | Sarah Ann Johnson | Social Worker | 1276 W River St, Suite 100, Boise, ID 83702-7066 | 2014-12-02 |
| 1932506508 | Access Behavioral Health Services, Inc | Clinic/Center | 1276 W River St, Suite 100, Boise, ID 83702-7066 | 2014-11-26 |
| 1609275825 | Ray Allen Ward | Counselor | 1276 W River St, Suite 100, Boise, ID 83702-7066 | 2014-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1013533231 | Sylvia Oh | Social Worker | 2118 S Latah St, Boise, ID 83705-3947 | 2020-06-23 |
| 1417577412 | Stacey Titus Pllc | Social Worker | 5440 W Franklin Rd Ste 201, Boise, ID 83705-6434 | 2020-04-20 |
| 1447888656 | Berndt and Associates In Psychcare LLC | Social Worker | 4477 W Emerald St Ste C275, Boise, ID 83706-2078 | 2020-04-01 |
| 1528690773 | Marc Adrian Dominguez | Social Worker | 1299 N Orchard St Ste 110, Boise, ID 83706-2266 | 2020-02-06 |
| 1235774407 | Wildflower Intuitive Center, LLC | Social Worker | 4696 W Overland Rd Ste 276, Boise, ID 83705-2877 | 2019-11-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1821550203 | Alturas Counseling | Social Worker | 204 S Cole Rd, Boise, ID 83709-0934 | 2019-04-03 |
| 1750859856 | Jani Lynn Belcoe | Social Worker | 3029 N 32nd St, Boise, ID 83703-5001 | 2018-11-06 |
| Find all providers in BOISE | ||||
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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.