REGENTS OF THE UNIVERSITY OF IDAHO CHILD & YOUTH STUDY CENTER (NPI# 1609902980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609902980 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVERSITY OF IDAHO CHILD & YOUTH STUDY CENTER |
| Other Organization Name | CHILD & YOUTH STUDY CENTER |
| Practice Address |
121 West Sweet Avenue Moscow ID 83843 |
| Mailing Address |
875 Perimeter Drive Ms 4061 Moscow ID 83844-4061 |
| Practice Telephone | 2088856191 |
| Practice Fax Number | 2088856188 |
| Mailing Telephone | 2088853588 |
| Mailing Fax Number | 2088853536 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2014-04-01 |
| Authorized Official Name | DR. GWEN ELAINE MITCHELL (DIRECTOR) |
| Authorized Official Telephone | 2088856191 |
| Authorized Official Credential | LPC, NCSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807220700 | 05 |
| Other Name | Type Code |
|---|---|
| Child & Youth Study Center | Doing Business As Name - Organization |
| Street Address |
121 WEST SWEET AVENUE |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497997431 | Andrew Dean Sapp | Psychologist | 3770 E. Black Canyon Hwy, Emmett, ID 83617-0678 | 2009-04-06 |
| 1053461186 | Frank Andrews | Psychologist | 220 S 2nd Ave, Hailey, ID 83333-8431 | 2007-01-11 |
| 1891704318 | Sara Bryn Morrow | Psychologist | 7905 N Meadowlark Way Ste E, Coeur D Alene, ID 83815-5041 | 2006-08-05 |
| 1568826204 | Kelsy Newton | Psychologist | 305 E Jefferson St, Boise, ID 83712-6273 | 2016-04-08 |
| 1508100876 | Big Lake Psychological Services, PC | Psychologist | 1809 E Sherman Ave, Coeur D Alene, ID 83814-5873 | 2012-11-26 |
| 1861755068 | Dan Earnest Day | Psychologist | 1550 N Crestmont Dr, Suite E, Meridian, ID 83642-2184 | 2012-06-21 |
| 1205121514 | Christine Kildow | Psychologist | 915 Parkcentre Way Ste 7, Nampa, ID 83651-1748 | 2011-06-15 |
| 1316243330 | St Luke's Regional Medical Center | Psychologist | 100 E Idaho St, Ste 200, Boise, ID 83712-6267 | 2011-02-09 |
| 1366750929 | Kendra J Westerhaus | Psychologist | 500 S 11th Ave Ste 204, Pocatello, ID 83201-4878 | 2010-09-16 |
| 1336201342 | Mark West Roberts | Psychologist | 921 S 8th Ave, Garrison Hall 525 Stop 8021, Pocatello, ID 83209-0002 | 2006-12-15 |
| 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.