| Human Supports Of Idaho | |
|
4477 W Emerald St Ste C-100 Boise ID 83706-2000 | |
| (208) 454-8389 | |
| (208) 454-8404 |
| Full Name | Human Supports Of Idaho |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4477 W Emerald St, Boise, Idaho |
| Authorized Official Name and Position | Alita Ruby (ADMINISTRATEIVE SERVICES MANAGER) |
| Authorized Official Contact | 2084548389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Human Supports Of Idaho Po Box 820 Caldwell ID 83606-0820 Ph: (208) 454-8389 | Human Supports Of Idaho 4477 W Emerald St Ste C-100 Boise ID 83706-2000 Ph: (208) 454-8389 |
| NPI Number | 1922340124 |
|---|---|
| Provider Enumeration Date | 03/26/2013 |
| Last Update Date | 10/13/2022 |
| Certification Date | 10/13/2022 |
| Medicare PECOS PAC ID | 0244485894 |
|---|---|
| Medicare Enrollment ID | O20130305000118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922340124 | NPI | - | NPPES |
| 20002419 | Other | ID | MEDICARE PTAN |
| Provider Name | Jennifer R Quick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770594020 PECOS PAC ID: 6305733502 Enrollment ID: I20040302001110 |
| Provider Name | Ninon M Germain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588705560 PECOS PAC ID: 7214996131 Enrollment ID: I20041006001251 |
| Provider Name | Pamela H Archuleta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578518676 PECOS PAC ID: 5799711453 Enrollment ID: I20050713001006 |
| Provider Name | Nichole M Oprins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619270071 PECOS PAC ID: 8022257179 Enrollment ID: I20130620000493 |
| Provider Name | Thadeus B Koontz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609010156 PECOS PAC ID: 3072757012 Enrollment ID: I20130913000262 |
| Provider Name | Deborah L Woodall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215166038 PECOS PAC ID: 4284954579 Enrollment ID: I20150528001299 |
| Provider Name | Michael T Chippolla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679969976 PECOS PAC ID: 0547577025 Enrollment ID: I20150916000368 |
| Provider Name | Brian P Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831510320 PECOS PAC ID: 3173896842 Enrollment ID: I20170830003262 |
| Provider Name | Duke M Nyarecha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235625914 PECOS PAC ID: 6406107093 Enrollment ID: I20180920001736 |
| Provider Name | Sheila D Chapdelaine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780039545 PECOS PAC ID: 4587905278 Enrollment ID: I20190405001863 |
| Provider Name | Lynnette M Khandaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396292421 PECOS PAC ID: 8123307105 Enrollment ID: I20190625001979 |
| Provider Name | Lisa M Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205289618 PECOS PAC ID: 4284965203 Enrollment ID: I20191004003099 |
| Provider Name | Sarah M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346768330 PECOS PAC ID: 9335414135 Enrollment ID: I20191028001804 |
| Provider Name | Becky J Bole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043621576 PECOS PAC ID: 5294951687 Enrollment ID: I20191121002661 |
| Provider Name | Earl Weston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114402450 PECOS PAC ID: 7810236361 Enrollment ID: I20200120000241 |
| Provider Name | Jayde Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023618659 PECOS PAC ID: 1456764117 Enrollment ID: I20210119002691 |
| Provider Name | Toni M Keel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841835782 PECOS PAC ID: 7719308535 Enrollment ID: I20210721002204 |
| Provider Name | Shana May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114699287 PECOS PAC ID: 1153710629 Enrollment ID: I20211123001131 |
| Provider Name | Craig M Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053841247 PECOS PAC ID: 5395122857 Enrollment ID: I20220523001043 |
| Provider Name | Stephan Edward France |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710052139 PECOS PAC ID: 5698156750 Enrollment ID: I20220720002455 |
| Provider Name | Amber Lynn Hoid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922621747 PECOS PAC ID: 2466835921 Enrollment ID: I20220816001373 |
| Provider Name | Megan Lee Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083357651 PECOS PAC ID: 7517343155 Enrollment ID: I20221004003723 |
| Provider Name | Jeanette M Steiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801523279 PECOS PAC ID: 3678957842 Enrollment ID: I20221006000814 |
| Provider Name | Meredith Ashley Sievers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265157531 PECOS PAC ID: 0840660015 Enrollment ID: I20230104001331 |
| Provider Name | Sara Joanne Mitchem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245947720 PECOS PAC ID: 1951772268 Enrollment ID: I20230125000333 |
| Provider Name | Becky Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275192098 PECOS PAC ID: 3274998786 Enrollment ID: I20230504002193 |
| Provider Name | Ashley Weiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821697749 PECOS PAC ID: 5193181717 Enrollment ID: I20230523003026 |
| Provider Name | Suzy Bird |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942748199 PECOS PAC ID: 9133587645 Enrollment ID: I20230615000720 |
| Provider Name | Mary Kay Gordon-brunner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003593914 PECOS PAC ID: 3577924307 Enrollment ID: I20230726002910 |
| Provider Name | Tamara Melville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760538805 PECOS PAC ID: 0143488668 Enrollment ID: I20231130003911 |
| Provider Name | Dena Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104208602 PECOS PAC ID: 3072964451 Enrollment ID: I20240110002153 |
| Provider Name | Ruxandra Fee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588212450 PECOS PAC ID: 2769834753 Enrollment ID: I20240116000116 |
| Provider Name | Leslie Pardue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326735911 PECOS PAC ID: 6901258433 Enrollment ID: I20240119001807 |
| Provider Name | Steven A Mauk |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1184873952 PECOS PAC ID: 5890147334 Enrollment ID: I20240119001910 |
| Provider Name | Rebecca Roth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104371293 PECOS PAC ID: 4183076441 Enrollment ID: I20240123000874 |
| Provider Name | Alyssa Peters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730602962 PECOS PAC ID: 7517319890 Enrollment ID: I20240123001674 |
| Provider Name | Megan C Segraves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396410304 PECOS PAC ID: 1557714995 Enrollment ID: I20240201000955 |
| Provider Name | Ki Benjamin Kurtz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194088591 PECOS PAC ID: 8022309038 Enrollment ID: I20240306002864 |
| Provider Name | Anthony Quinn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558621151 PECOS PAC ID: 0547489619 Enrollment ID: I20240329001398 |
| Provider Name | Casey Payne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326716135 PECOS PAC ID: 3274972096 Enrollment ID: I20240412002387 |
| Provider Name | Keith James Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134904949 PECOS PAC ID: 8426497140 Enrollment ID: I20240415001799 |
| Provider Name | Sarah Marie Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942899919 PECOS PAC ID: 6406296946 Enrollment ID: I20240430004010 |
| Provider Name | Veronica M Grimaldo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720799612 PECOS PAC ID: 4587109152 Enrollment ID: I20240709000507 |
| Provider Name | Amy Ives |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629627948 PECOS PAC ID: 0042756520 Enrollment ID: I20240719002821 |
| Provider Name | Kevin Colin Soran Henson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194552240 PECOS PAC ID: 4082155486 Enrollment ID: I20240925004144 |
| Provider Name | Brian Berrett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396107595 PECOS PAC ID: 6103104815 Enrollment ID: I20241011002665 |
| Provider Name | James Mauldin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619191012 PECOS PAC ID: 0547338493 Enrollment ID: I20241016000017 |
| Provider Name | Tiffany Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245918093 PECOS PAC ID: 2860925229 Enrollment ID: I20241024001359 |
| Provider Name | Talita Calazans Jackson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801231618 PECOS PAC ID: 3779921754 Enrollment ID: I20241029002257 |
| Provider Name | Jennie R Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023868411 PECOS PAC ID: 0547794398 Enrollment ID: I20241115001220 |
| Provider Name | Juelette Higuera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073671681 PECOS PAC ID: 4082840202 Enrollment ID: I20241119004328 |
| Provider Name | Marty T. Cooke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831246594 PECOS PAC ID: 1355861873 Enrollment ID: I20250226003621 |
| Provider Name | William G Longpre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568078285 PECOS PAC ID: 5395268817 Enrollment ID: I20250325003643 |
Sunderlin Behavioral Interventions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3113 W Rose Hill St, Boise, ID 83705 Phone: 208-297-1405 Fax: 805-823-4462 | |
Boise Behavioral Medicine Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7227 W Potomac Dr, Boise, ID 83704 Phone: 208-314-1770 | |
Phyllis Mckinley Viviani, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 N Latah St Ste C, Boise, ID 83706 Phone: 208-918-2810 | |
Saint Alphonsus Regional Medical Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Allumbaugh St, Boise, ID 83704 Phone: 208-367-3069 Fax: 208-367-3002 | |
Saint Alphonsus Regional Medical Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 N Curtis Rd Ste 204, Boise, ID 83706 Phone: 208-367-3315 | |
Living Well, Inc, Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6003 W Overland Rd, Suite 101, Boise, ID 83709 Phone: 208-322-2412 Fax: 208-345-2077 | |
Continual Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 W Bannock St # Ss, Boise, ID 83702 Phone: 208-602-7007 |