SHIRLEY JOANN KOESTER (NPI# 1497028161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497028161 |
| Entity Type | Organization |
| Organization Name | SHIRLEY JOANN KOESTER |
| Other Organization Name | ACTIVE CHANGE CENTER |
| Practice Address |
901 Pier View Dr Suite 204 Idaho Falls ID 83402-5070 |
| Practice Telephone | 2084037488 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |
| Authorized Official Name | MRS. JOANN KOESTER (OWNER) |
| Authorized Official Telephone | 2084037488 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LCPC206 | ID | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| ACTIVE CHANGE CENTER | Doing Business As Name - Organization |
| Street Address |
901 PIER VIEW DR SUITE 204 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-5070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1427670314 | Richard Meyers | Counselor | 2052 Jennie Lee Dr Ste 2, Idaho Falls, ID 83404-7056 | 2020-05-13 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1063923597 | Jared Roberts | Counselor | 550 W Sunnyside Rd, Idaho Falls, ID 83402-4619 | 2017-10-24 |
| 1982051694 | Stephen Nelson | Counselor | 1582 N Holmes Ave, Idaho Falls, ID 83401-2032 | 2016-05-23 |
| 1043689029 | Kirk Thiemann | Counselor | 115 E 16th St, Idaho Falls, ID 83404-5919 | 2015-09-19 |
| 1942632153 | Kevin L Lindley | Counselor | 1904 Jennie Lee Dr, Idaho Falls, ID 83404-6159 | 2013-07-30 |
| 1710325444 | Eric Olson | Counselor | 320 B St Ste 110, Idaho Falls, ID 83402-3547 | 2013-06-04 |
| 1427315084 | Healing Heands Reiki and Massage, LLC | Counselor | 429 B St, Idaho Falls, ID 83402-3544 | 2012-04-19 |
| 1326360942 | Bethena (beth) Loree Boettcher | Counselor | 1904 Jennie Lee Dr., Idaho Falls, ID 83404 | 2010-02-23 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on SHIRLEY JOANN KOESTER.
| 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.