MR. BRENT STANLEY PACKER (NPI# 1255677076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255677076 |
| Entity Type | Individual |
| Full Name | MR. BRENT STANLEY PACKER |
| Credential | BS |
| Practice Address |
1190 York Dr Blackfoot ID 83221-3621 |
| Practice Telephone | 2082010144 |
| Mailing Telephone | 2082010144 |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902959018 | Brent Packer | General Practice | 4220 Ingleside Dr Se, Lacey, WA 98503-2108 | 2007-01-19 |
| 1104931633 | Brent Taylor Packer | Dentist | 1400 N Gilbert Rd, Suite A, Gilbert, AZ 85234-2328 | 2006-08-21 |
| Street Address |
1190 YORK DR |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-3621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1174980205 | Yezenia Lora-salas | Social Worker | Rr 3 Box 288, Blackfoot, ID 83221-9792 | 2016-01-20 |
| 1174656664 | J&m Mental Health, Inc. | Social Worker | 60 N Broadway St, Blackfoot, ID 83221-2706 | 2007-03-13 |
| 1316409337 | Casandra Dayley Serr | Social Worker | 720 East Alice, Blackfoot, ID 83221 | 2019-04-01 |
| 1598224826 | Larry Christian Jones | Social Worker | 60 N Broadway St, Blackfoot, ID 83221-2706 | 2019-03-16 |
| 1841654381 | Jennifer Joy De Mille | Social Worker | 720 East Alice, Blackfoot, ID 83221 | 2016-04-11 |
| 1306203468 | Still Waters Counseling LLC | Social Worker | 1309 Camas St, Blackfoot, ID 83221-3060 | 2016-01-20 |
| 1104236652 | Jodi Munson Phillips | Social Worker | 150 S Broadway St, Blackfoot, ID 83221-2711 | 2014-05-06 |
| 1154731529 | Shanna Clayson | Social Worker | 150 S Broadway St, Blackfoot, ID 83221-2711 | 2014-05-06 |
| Find all providers in BLACKFOOT | ||||
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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.