PRO ACTIVE ADVANTAGE LLC (NPI# 1366562316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366562316 |
| Entity Type | Organization |
| Organization Name | PRO ACTIVE ADVANTAGE LLC |
| Other Organization Name | PRO ACTIVE BEHAVIORAL HEALTH |
| Practice Address |
215 University Dr Gooding ID 83330-6155 |
| Practice Telephone | 2089345880 |
| Practice Fax Number | 2089345876 |
| Mailing Telephone | 2089345880 |
| Mailing Fax Number | 2089345876 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2015-07-08 |
| Authorized Official Name | FRANK J. KNIGHT (CEO) |
| Authorized Official Telephone | 2089345880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8063821 | 05 |
| Other Name | Type Code |
|---|---|
| Pro Active Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407253669 | Pro Active Advantage LLC | Community/Behavioral Health | 215 University Dr, Gooding, ID 83330-6155 | 2014-12-03 |
| Street Address |
215 UNIVERSITY DR |
| City | GOODING |
| State | ID |
| Zip Code | 83330-6155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669820346 | Felix Michael Arnold | Social Worker | 215 University Dr, Gooding, ID 83330-6155 | 2016-06-02 |
| 1861873853 | Chelsey Winkle | Social Worker | 215 University Dr, Gooding, ID 83330-6155 | 2015-06-15 |
| 1407253669 | Pro Active Advantage LLC | Community/Behavioral Health | 215 University Dr, Gooding, ID 83330-6155 | 2014-12-03 |
| 1316344625 | Joshua D Cooke | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2014-12-02 |
| 1649525049 | Brandon Douglas Knight | Social Worker | 215 University Dr, Gooding, ID 83330-6155 | 2012-07-23 |
| 1023371457 | Heather Kaye Birkhimer | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2012-06-20 |
| 1346503877 | Denise Marie Jensen | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2012-06-19 |
| 1093027377 | Stephanie Jan Bowles | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2010-07-02 |
| 1730200460 | Pro Active Advantage, LLC | Psychologist | 215 University Dr, Gooding, ID 83330-6155 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1083959332 | Lydia Jo Missal | Counselor | 1832 E. 1750 S., Gooding, ID 83330 | 2012-11-27 |
| 1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
| 1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
| 1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
| 1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
| 1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
| 1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| Find all providers in zip 83330 | ||||
| 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 |
|---|---|---|---|---|
| 1093027377 | Stephanie Jan Bowles | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2010-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841814 | Bright Beginnings Counseling | Counselor | 113 Rosebud Dr, Rupert, ID 83350-9146 | 2020-11-02 |
| 1962029298 | Kami Roach | Counselor | 155 2nd Ave N Ste 201, Twin Falls, ID 83301-6163 | 2020-07-02 |
| 1457975781 | Nikhail Sinea Maestas | Counselor | 3649 N Lakeharbor Ln, Boise, ID 83703-6913 | 2020-06-02 |
| 1609415199 | Summit Creek Counseling LLC | Counselor | 57 Bannock St, Malad City, ID 83252-1240 | 2019-12-31 |
| 1588202907 | Brianna Dannielle Windhorst | Counselor | 611 Wilson Ave Ste 5, Pocatello, ID 83201-5046 | 2019-12-16 |
| 1972145308 | Sarah Barnes | Counselor | 2068 S Eagle Rd, Meridian, ID 83642-6707 | 2019-10-17 |
| 1023650538 | Sarah Mcdermott | Counselor | 733 N Main St Ste C, Bellevue, ID 83313-6068 | 2019-10-16 |
| 1417598384 | Barton Vandenburg | Counselor | 1001 N 7th Ave, Pocatello, ID 83201-5761 | 2019-10-02 |
| 1932759404 | Stephanie Le Anne Beidman | Counselor | 800 Main St # 11, Lewiston, ID 83501-1838 | 2019-09-17 |
| 1750930277 | Julie Anne Meza | Counselor | 8691 W Mediterranean Ct, Boise, ID 83709-2600 | 2019-09-06 |
| 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.