WILLOW SAGE SERVICES LLC (NPI# 1538611652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538611652 |
| Entity Type | Organization |
| Organization Name | WILLOW SAGE SERVICES LLC |
| Practice Address |
2475 Mesa St Idaho Falls ID 83401-3312 |
| Practice Telephone | 2082065276 |
| Mailing Telephone | 2082065276 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2017-01-23 |
| Authorized Official Name | MRS. TRESIA JONES (OWNER) |
| Authorized Official Telephone | 2082065276 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
2475 MESA ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-3312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972052546 | Dustin Jones | Specialist/Technologist | 2475 Mesa St, Idaho Falls, ID 83401-3312 | 2016-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285154054 | Evergreen Counseling LLC | Counselor | 1920 E 17th St Ste 240, Idaho Falls, ID 83404-8036 | 2017-06-22 |
| 1689066896 | Clyde Tigner | Counselor | 560 Moonlite Dr, Idaho Falls, ID 83402-2336 | 2015-02-25 |
| 1114322906 | Jodi H Richins | Counselor | 2429 Jafer Ct, Idaho Falls, ID 83404-5587 | 2014-10-23 |
| 1336576743 | Mary Louise Tompkins | Counselor | 2275 West Broadway, Suite G, Idaho Falls, ID 83402 | 2013-09-30 |
| 1962742957 | James Resare | Counselor | 2100 Niagara St, Idaho Falls, ID 83404-8025 | 2013-02-27 |
| 1710244371 | Laura Lee Shepherd Klosterman | Counselor | 548 Lomax St, Idaho Falls, ID 83401-2634 | 2012-04-19 |
| 1558657098 | Kellie J Brown | Counselor | 2001 S. Woodruff Ste. 6, Idaho Falls, ID 83402 | 2011-06-23 |
| 1477766905 | Tueller Counseling Inc | Counselor | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2007-05-08 |
| 1467574442 | Lisa D. Calderwood | Counselor | 703 John Adams Pkwy, Idaho Falls, ID 83401-4023 | 2007-04-03 |
| 1497807416 | Katie Marie Anderson | Counselor | 1740 E 17th St Steb, Idaho Falls, ID 83404 | 2007-01-18 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on WILLOW SAGE SERVICES 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.