PHILIP N MACKINNON (NPI# 1376681098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376681098 |
| Entity Type | Individual |
| Full Name | PHILIP N MACKINNON |
| Credential | PH D |
| Practice Address |
415 6th St Lewiston ID 83501-2431 |
| Practice Telephone | 2087432511 |
| Practice Fax Number | 2087995554 |
| Mailing Telephone | 2087432511 |
| Mailing Fax Number | 2087995554 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY235 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8373920 | 05 | |
| WA | DEPT OF LABOR AND INDUSTR | 0215850 | 01 |
| ID | REGENCE OF IDAHO | 10016370 | 01 |
| ID | BLUE CROSS OF IDAHO IND | N5905 | 01 |
| Street Address |
415 6TH ST |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-2431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164414595 | William Westel Rowe | Internal Medicine | 415 6th St, Lewiston, ID 83501-2434 | 2005-08-22 |
| 1558995316 | Hospitalist Medicine Physicians of Idaho- Nampa Pllc | Emergency Medicine | 415 6th St, Lewiston, ID 83501-2431 | 2020-03-02 |
| 1003465360 | Kyle James Daly | Nurse Anesthetist, Certified Registered | 415 6th St, Lewiston, ID 83501-2431 | 2019-09-10 |
| 1184273708 | Kevin Dombey | Physician Assistant | 415 6th St, Lewiston, ID 83501-2431 | 2019-09-06 |
| 1952962813 | Andrea Bowen | Social Worker | 415 6th St, Lewiston, ID 83501-2431 | 2019-06-21 |
| 1881167609 | Christie Kytonen | Licensed Practical Nurse | 415 6th St, Lewiston, ID 83501-2431 | 2019-01-03 |
| 1295206134 | Nicholas Tieu | Physician Assistant | 415 6th St, Lewiston, ID 83501-2434 | 2018-12-17 |
| 1932670866 | Jerilyn R Bodey | Nurse Practitioner | 415 6th St, Lewiston, ID 83501 | 2018-12-17 |
| 1154800522 | Joanne Vestal | Pharmacist | 415 6th St, Lewiston, ID 83501-2434 | 2018-08-07 |
| 1174017701 | Samantha Lynn Musser | Registered Nurse | 415 6th St, Lewiston, ID 83501-2431 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1013353739 | Bates College Health Center | Psychologist | 31 Campus Ave, Lewiston, ME 04240-6009 | 2013-05-21 |
| 1053627133 | Frank Ellis | Psychologist | 111 Pond Rd, Lewiston, ME 04240-1604 | 2010-08-26 |
| 1184854630 | Eventus Maine LLC | Psychologist | 1180 Lisbon St, Lewiston, ME 04240-5059 | 2009-07-18 |
| 1629159140 | James R Phillips | Psychologist | 532 Bryden Ave, Lewiston, ID 83501-4445 | 2006-10-18 |
| 1376634345 | Richard Ballou Gallaher Jr. | Psychologist | 513 Thain Road, Lewiston, ID 83501-4140 | 2006-09-27 |
| 1386682466 | James Cogan | Psychologist | 443 Main St, Lewiston, ME 04240-6733 | 2006-06-02 |
| 1124078753 | George R Sheckart | Psychologist | 33r Mollison Way, Lewiston, ME 04240 | 2006-05-12 |
| 1689039422 | Annie Derthick | Psychologist | 76 High St, Lewiston, ME 04240 | 2015-12-21 |
| 1700262243 | Robert Paul Carnicella | Psychologist | 72 Strawberry Ave, Lewiston, ME 04240-5952 | 2015-08-06 |
| Find all providers in LEWISTON | ||||
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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.