PRO ACTIVE ADVANTAGE LLC (NPI# 1407253669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407253669 |
| 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 |
| Mailing Address |
562 Shoup Ave W Twin Falls ID 83301-5029 |
| Practice Telephone | 2089345880 |
| Mailing Telephone | 2087340407 |
| Mailing Fax Number | 2087343534 |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | PAT MARECKI (HUMAN RESOURCES) |
| Authorized Official Telephone | 2089345880 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | LPC-5654 | ID | Agencies |
| Other Name | Type Code |
|---|---|
| Pro Active Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366562316 | Pro Active Advantage LLC | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2007-03-30 |
| Street Address |
215 UNIVERSITY DR |
| City | GOODING |
| State | ID |
| Zip Code | 83330-6155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366562316 | Pro Active Advantage LLC | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2007-03-30 |
| 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 |
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124141023 | Behavior Strategies | Community/Behavioral Health | 202 14th Ave E, Gooding, ID 83330-1829 | 2007-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607704 | Mays Healing | Community/Behavioral Health | 1024 E Amity Ave, Nampa, ID 83686-5502 | 2020-10-22 |
| 1811502313 | Mindful Moments LLC | Community/Behavioral Health | 15636 N Highway 41 Ste 700, Rathdrum, ID 83858-8710 | 2020-09-10 |
| 1467064139 | Treasure Valley Compassionate Therapy, LLC | Community/Behavioral Health | 101 11th Ave S Ste 225, Nampa, ID 83651-3918 | 2020-08-23 |
| 1538779566 | Carolyn Elizabeth Barndt | Community/Behavioral Health | 1302 12th St, Lewiston, ID 83501-2932 | 2020-08-04 |
| 1053938779 | Halo Health Services LLC | Community/Behavioral Health | 1111 S Orchard St, Boise, Id 83705, Boise, ID 83705 | 2020-06-29 |
| 1023634672 | Padron Counseling Services, LLC | Community/Behavioral Health | 522 Lomax St, Idaho Falls, ID 83401-2634 | 2020-06-19 |
| 1245854454 | Ken Wells Counseling | Community/Behavioral Health | 6654 E Bend Ridge St, Boise, ID 83716-5623 | 2020-06-03 |
| 1982227534 | Bonnie Bray | Community/Behavioral Health | 99 East Fork Road, Hailey, ID 83333 | 2020-05-18 |
| 1083236079 | Nakale Ball | Community/Behavioral Health | 3861 N Maple Grove Rd, Boise, ID 83704-4227 | 2020-05-12 |
| 1487283917 | Emma Orthel Therapy, Pllc | Community/Behavioral Health | 210 N 3rd E, Mountain Home, ID 83647-2733 | 2020-04-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PRO ACTIVE ADVANTAGE LLC.
| 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.