BANNOCK COUNTY FAMILY TREATMENT CENTER (NPI# 1427437383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427437383 |
| Entity Type | Organization |
| Organization Name | BANNOCK COUNTY FAMILY TREATMENT CENTER |
| Practice Address |
141 N 6th Ave Pocatello ID 83201-6209 |
| Practice Telephone | 2082367089 |
| Practice Fax Number | 2082367097 |
| Mailing Telephone | 2082367089 |
| Mailing Fax Number | 2082367097 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |
| Authorized Official Name | MRS. KIMBERLY JO ANDREW (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 2082367089 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNOCK COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
141 N 6TH AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-6209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437785607 | Tamra J Peterson | Counselor | 1246 Yellowstone Ave Bldg F, Pocatello, ID 83201-4374 | 2020-03-19 |
| 1689218018 | D6 Treatment | Counselor | 1001 N 7th Ave Ste 260, Pocatello, ID 83201-5788 | 2019-10-29 |
| 1497247761 | Vanessa Lynn Almy | Counselor | 5231 W Moonlight Mine Rd, Pocatello, ID 83201-9013 | 2018-06-03 |
| 1598192734 | Bryson Kay Vaughan | Counselor | 110 S. 19th Ave., Pocatello, ID 83201 | 2013-10-02 |
| 1013275544 | Matthew R Christensen | Counselor | 5230 W Moonlight Mine Rd., Pocatello, ID 83201-8320 | 2012-05-03 |
| 1528366424 | Gateway Counseling Incorporated | Counselor | 151 N 3rd Ave Ste 330, Pocatello, ID 83201-6331 | 2011-03-02 |
| 1497081681 | Justin Dean Zierke | Counselor | 1070 Hiline Rd Ste 210, Pocatello, ID 83201-2947 | 2009-10-23 |
| 1770741407 | Jeannette M Sapp | Counselor | 303 N 12th Ave, 204, Pocatello, ID 83201-4746 | 2008-05-29 |
| 1679648638 | Rebecca Hardy | Counselor | 1257 East Center Street, Pocatello, ID 83201-1257 | 2006-11-22 |
| 1730787201 | Kari Y Wolbert | Counselor | 707 N 7th Ave, Pocatello, ID 83201-5785 | 2020-10-15 |
| Find all providers in POCATELLO | ||||
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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.