MS. TAMARA K. PETTINGILL


Address: 2677 Teton Plaza Drive, Idaho Falls, ID 83404
Phone: 2085429919

MS. TAMARA K. PETTINGILL (NPI# 1629081864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629081864
Entity Type Individual
Full Name MS. TAMARA K. PETTINGILL
Credential LCSW
Practice Address 2677 Teton Plaza Drive
Idaho Falls
ID 83404
Practice Telephone 2085429919
Practice Fax Number 2085426272
Mailing Telephone 2085429919
Mailing Fax Number 2085426272
Enumeration Date 2006-08-15
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor LCSW-24477 ID Behavioral Health & Social Service Providers

Office Location

Street Address 2677 TETON PLAZA DRIVE
City IDAHO FALLS
State ID
Zip Code 83404

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NPI Name Taxonomy Address Enumeration
1437750809 Joshua M Murphy Dentist 1580 Elk Creek Dr., Idaho Falls, ID 83404 2020-11-03
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1942863600 Muhammad Arslan Khan Student in an Organized Health Care Education/Training Program 2860 Channing Way Suite 214, Idaho Falls, ID 83404 2019-04-18
1942771043 Physician's Choice Cardiology, Pllc Internal Medicine 3302 Valencia, Suite 201, Idaho Falls, ID 83404 2018-12-16
1609358761 Cardiac Cath Lab of Idaho Falls Internal Medicine 3311 Valencia Drive, Idaho Falls, ID 83404 2018-09-05
1083196380 Hannah Golden Occupational Therapist 1460 Elk Creek, Idaho Falls, ID 83404 2018-09-04
1316423049 Lindsay Sessions Speech-Language Pathologist 2210 Niagara St, Idaho Falls, ID 83404 2018-07-16
1720574023 Bmh, Inc. Anesthesiology 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 2018-07-10
1093237935 Jason Earl Bailey Contractor 3100 S Woodruff Ave., Idaho Falls, ID 83404 2017-07-12
1235682121 Mountain Falls Quick Care Clinic/Center 1995 E 17th St #1, Idaho Falls, ID 83404 2016-07-27
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City IDAHO FALLS
Zip Code 83404

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Dataset Information

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.

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