BETSY PACK PETERSEN (NPI# 1952852436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952852436 |
| Entity Type | Individual |
| Full Name | BETSY PACK PETERSEN |
| Other Name | BETSY LEANNE PACK |
| Credential | LMSW |
| Practice Address |
2267 Teton Plz Idaho Falls ID 83404-6486 |
| Practice Telephone | 2085220140 |
| Practice Fax Number | 2085247335 |
| Mailing Telephone | 2085220140 |
| Mailing Fax Number | 2085247335 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2018-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LMSW-38030 | ID | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | LMSW-38030 | ID | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 10930 (LMSW) | TN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 501 Adesa Blvd, Suite A-150, Lenoir City, TN 37771 | 8659868082 | 8659865890 |
| Street Address |
2267 TETON PLZ |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-6486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811913676 | Pettingill Counseling Services | Counselor | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2006-07-14 |
| 1205375490 | Katie Michelle Mcfarland | Counselor | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2017-02-21 |
| 1659816528 | Human Dynamics and Development | Community/Behavioral Health | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2016-12-30 |
| 1760924799 | Shannon Kay Johnson | Social Worker | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2016-11-08 |
| 1528450137 | Wendy Loyd | Counselor | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2015-02-19 |
| 1184022493 | Sarah Hernandez | Clinic/Center | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2014-12-18 |
| 1508264482 | Eric Davenport | Counselor | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2014-12-09 |
| 1043652530 | Tawnya E Nichols | Behavioral Analyst | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2013-07-24 |
| 1144591934 | Emily Ricks Smith | Social Worker | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2012-01-25 |
| 1366730012 | Jerilyn Pence | Counselor | 2267 Teton Plz, Idaho Falls, ID 83404-6486 | 2011-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 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 |
| Find all providers in zip 83404 | ||||
| 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 | 83404 |
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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.