| Northend Wellness, Llc | |
|
1310 W Hays St Boise ID 83702-5025 | |
| (208) 949-6765 | |
| Not Available |
| Full Name | Northend Wellness, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1310 W Hays St, Boise, Idaho |
| Authorized Official Name and Position | David Cummins (OWNER) |
| Authorized Official Contact | 2089496765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northend Wellness, Llc 1310 W Hays St Boise ID 83702-5025 Ph: () - | Northend Wellness, Llc 1310 W Hays St Boise ID 83702-5025 Ph: (208) 949-6765 |
| NPI Number | 1306230958 |
|---|---|
| Provider Enumeration Date | 03/21/2015 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/28/2023 |
| Medicare PECOS PAC ID | 2163720848 |
|---|---|
| Medicare Enrollment ID | O20160413000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306230958 | NPI | - | NPPES |
| 1669466827 | Other | ID | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 202232 (Idaho) | Primary |
| Provider Name | David Michael Cummins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669466827 PECOS PAC ID: 6608893987 Enrollment ID: I20051026000447 |
| Provider Name | Thomas C Ahlrichs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013135078 PECOS PAC ID: 1759482102 Enrollment ID: I20070730000066 |
| Provider Name | Thomas J Childers-scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578050076 PECOS PAC ID: 2264808336 Enrollment ID: I20230725003203 |
| Provider Name | Garrett Price |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114405925 PECOS PAC ID: 5496192387 Enrollment ID: I20240327003067 |
| Provider Name | Martin M Cutler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104110782 PECOS PAC ID: 1557872926 Enrollment ID: I20250613001921 |
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