IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH CLINIC SANDPOINT (NPI# 1467589184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467589184 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH CLINIC SANDPOINT |
| Practice Address |
207 Larkspur St Ponderay ID 83852-5011 |
| Practice Telephone | 2082654535 |
| Practice Fax Number | 2082634198 |
| Mailing Telephone | 2082654535 |
| Mailing Fax Number | 2082634198 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2016-08-25 |
| Authorized Official Name | HOLLY BONWELL (PROGRAM MANAGER) |
| Authorized Official Telephone | 2087691406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8073679 | 05 | |
| BLUE SHIELD | 000010018348 | 01 | |
| BLUE CROSS OF IDAHO | HW256 | 01 |
| Street Address |
207 LARKSPUR ST |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852-5011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417084716 | Idaho Dept of Health & Welfare Reg 1 Ahm Psr Sandpoint | Clinic/Center | 207 Larkspur St, Ponderay, ID 83852-5011 | 2007-02-27 |
| 1972084937 | Carol Young | Counselor | 207 Larkspur St, Ponderay, ID 83852-5011 | 2018-08-27 |
| 1215390158 | Joanna Richter | Registered Nurse | 207 Larkspur St, Ponderay, ID 83852-5011 | 2016-03-29 |
| 1407218209 | Barbara Thompson | Social Worker | 207 Larkspur St, Ponderay, ID 83852-5011 | 2016-03-22 |
| 1003277039 | Anna Louise Lawrence | Social Worker | 207 Larkspur St, Ponderay, ID 83852-5011 | 2016-03-18 |
| 1114388105 | Sadie Green | Social Worker | 207 Larkspur St, Ponderay, ID 83852-5011 | 2016-03-17 |
| 1265892210 | Elizabeth Larsen | Developmental Therapist | 207 Larkspur St, Ponderay, ID 83852-5011 | 2016-03-03 |
| 1801256227 | Susan Hansen | Developmental Therapist | 207 Larkspur St, Ponderay, ID 83852-5011 | 2016-02-26 |
| 1013239268 | Jennifer Smith | Marriage & Family Therapist | 207 Larkspur St, Ponderay, ID 83852-5011 | 2010-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808019 | Helping Hearts Counseling Center, Pllc | Clinic/Center | 310 Cleveland Blvd, Caldwell, ID 83605-3624 | 2020-10-12 |
| 1811502438 | Dale Wilson Counseling and Evaluation | Clinic/Center | 6126 W State St Ste 101, Boise, ID 83703-2741 | 2020-09-10 |
| 1144843285 | Whole Health Counseling LLC | Clinic/Center | 2616 W Jefferson St, Boise, ID 83702-4713 | 2020-05-23 |
| 1033740865 | Jackie Nelson, Pllc | Clinic/Center | 202 N 9th St Ste 401c, Boise, ID 83702-5770 | 2020-01-30 |
| 1437621646 | Joanne Burgio Phd LLC | Clinic/Center | 3061 S Meridian Rd Ste 150, Meridian, ID 83642-7962 | 2018-12-28 |
| 1700394822 | Lookout Behavioral Health LLC | Clinic/Center | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2018-01-11 |
| 1346759495 | Pacific Mind Institute | Clinic/Center | 2596 N Stokesberry Pl Ste 165, Meridian, ID 83646-6281 | 2017-09-20 |
| 1336599976 | Easy Go Express | Clinic/Center | 3551 W Antelope Rd, Moore, ID 83255-8754 | 2016-06-14 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1447695630 | Susan M. Beglinger, Ltd | Clinic/Center | 206 E Indiana Ave, Suite 112, Coeur D Alene, ID 83814-2969 | 2013-05-01 |
| 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.