| Human Dynamics and Diagnostics, LLC | |
|
2267 Teton Plz Idaho Falls ID 83404-6486 | |
| (208) 524-4953 | |
| (208) 524-7335 |
| Full Name | Human Dynamics and Diagnostics, LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2267 Teton Plz, Idaho Falls, Idaho |
| Authorized Official Name and Position | Mellissa Ockerman (OFFICE MANAGER) |
| Authorized Official Contact | 2085220140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Human Dynamics and Diagnostics, LLC 2267 Teton Plz Idaho Falls ID 83404-6486 Ph: (208) 524-4953 | Human Dynamics and Diagnostics, LLC 2267 Teton Plz Idaho Falls ID 83404-6486 Ph: (208) 524-4953 |
| NPI Number | 1346368198 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 04/25/2023 |
| Certification Date | 02/16/2023 |
| Medicare PECOS PAC ID | 1153644547 |
|---|---|
| Medicare Enrollment ID | O20141215002111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346368198 | NPI | - | NPPES |
| 806878600 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
| Provider Name | Bonnie C Horsburgh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245567791 PECOS PAC ID: 0547583718 Enrollment ID: I20150324002273 |
| Provider Name | Shannon K Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760924799 PECOS PAC ID: 2668713058 Enrollment ID: I20190411003182 |
| Provider Name | Danielle C Connella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043871189 PECOS PAC ID: 6002248093 Enrollment ID: I20191113000219 |
| Provider Name | Cory Evan Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740919604 PECOS PAC ID: 5395126460 Enrollment ID: I20220720002637 |
| Provider Name | Dallen Ray Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184257644 PECOS PAC ID: 1557729571 Enrollment ID: I20230623002244 |
| Provider Name | Mark Alan Kelsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497046718 PECOS PAC ID: 8426419706 Enrollment ID: I20230802003956 |
| Provider Name | Carmen Melissa Stites |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881118131 PECOS PAC ID: 2769831858 Enrollment ID: I20231214002493 |
| Provider Name | Shawn L Thurber |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457453789 PECOS PAC ID: 6305297383 Enrollment ID: I20240104001603 |
| Provider Name | Nathan J Lausch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841068871 PECOS PAC ID: 8527558154 Enrollment ID: I20251103003381 |
| Provider Name | Toni M Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285484659 PECOS PAC ID: 9931691284 Enrollment ID: I20251124002625 |
| Provider Name | Isobel C Pawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962116780 PECOS PAC ID: 2860985207 Enrollment ID: I20251203003180 |
| Provider Name | Austin M Fontes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457042814 PECOS PAC ID: 0648765255 Enrollment ID: I20251222000383 |
| Provider Name | Kayleigh Krupp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437843760 PECOS PAC ID: 9931688520 Enrollment ID: I20260204002011 |
Sullivan Mental Health Services LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-523-1558 Fax: 208-529-4788 |
Youth and Family Renewal Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2935 Rollandet St, Idaho Falls, ID 83402 Phone: 208-542-2905 Fax: 208-522-2427 |
Independence, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1230 N Skyline Dr, Ste. A, Idaho Falls, ID 83402 Phone: 208-524-0881 Fax: 208-524-0886 |
Life Quest Family Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 586 1st St, Idaho Falls, ID 83401 Phone: 208-529-2920 |
Access Point Family Sevices Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2680 Channing Way, Idaho Falls, ID 83404 Phone: 208-522-4026 Fax: 208-522-4138 |
Childrens Supportive Services Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1565 E Lincoln Rd, Idaho Falls, ID 83401 Phone: 208-524-8996 Fax: 208-524-1205 |