| Northwest Neurobehavioral Health, Llc | |
|
2076 S Eagle Rd Meridian ID 83642-6707 | |
| (208) 955-7333 | |
| Not Available |
| Full Name | Northwest Neurobehavioral Health, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2076 S Eagle Rd, Meridian, Idaho |
| Authorized Official Name and Position | Jennifer A La Jeunesse (CO-OWNER) |
| Authorized Official Contact | 2082839121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Neurobehavioral Health, Llc 2076 S Eagle Rd Meridian ID 83642-6707 Ph: (208) 955-7333 | Northwest Neurobehavioral Health, Llc 2076 S Eagle Rd Meridian ID 83642-6707 Ph: (208) 955-7333 |
| NPI Number | 1013223445 |
|---|---|
| Provider Enumeration Date | 08/23/2010 |
| Last Update Date | 08/17/2015 |
| Medicare PECOS PAC ID | 0446432512 |
|---|---|
| Medicare Enrollment ID | O20110310000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013223445 | NPI | - | NPPES |
| 1369079 | Other | ID | MEDICARE PTAN |
| Provider Name | Eva L Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487615464 PECOS PAC ID: 1759382831 Enrollment ID: I20070117000238 |
| Provider Name | Mark A Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962443101 PECOS PAC ID: 3173798535 Enrollment ID: I20111213000671 |
| Provider Name | Melinda L Jorgensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053556258 PECOS PAC ID: 5991955239 Enrollment ID: I20121023000775 |
| Provider Name | Ann M Corey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821359522 PECOS PAC ID: 3779722814 Enrollment ID: I20130620000364 |
| Provider Name | James A Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053626085 PECOS PAC ID: 4789866856 Enrollment ID: I20140807000614 |
| Provider Name | Jeffrey D Hall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053568816 PECOS PAC ID: 9234311309 Enrollment ID: I20140808000004 |
| Provider Name | Carolyn S Golden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740314228 PECOS PAC ID: 9234356213 Enrollment ID: I20140814002779 |
| Provider Name | Laura J Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245467620 PECOS PAC ID: 9133301203 Enrollment ID: I20140815000588 |
| Provider Name | Marcos Moreno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528491834 PECOS PAC ID: 7113210998 Enrollment ID: I20160802000064 |
| Provider Name | Kara M Nixon |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1134663008 PECOS PAC ID: 5496015224 Enrollment ID: I20180215002591 |
| Provider Name | Juli E Bohlman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477831592 PECOS PAC ID: 0648514570 Enrollment ID: I20181204002944 |
| Provider Name | Ryan Manwaring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447745401 PECOS PAC ID: 9739424151 Enrollment ID: I20181212003494 |
| Provider Name | Stacey L Titus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801244843 PECOS PAC ID: 4082950688 Enrollment ID: I20190117001958 |
| Provider Name | Kelsy A Newton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568826204 PECOS PAC ID: 9032404025 Enrollment ID: I20190128000186 |
| Provider Name | Paulette A Flores |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982917472 PECOS PAC ID: 8325214026 Enrollment ID: I20200123002531 |
| Provider Name | Ashley M Loeb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013385384 PECOS PAC ID: 0143657999 Enrollment ID: I20200303002611 |
| Provider Name | Alicia R Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497265367 PECOS PAC ID: 0547698466 Enrollment ID: I20200306001818 |
| Provider Name | Eric E Silk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639541774 PECOS PAC ID: 8820429210 Enrollment ID: I20200519003186 |
| Provider Name | Stacey M Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235875675 PECOS PAC ID: 8820471550 Enrollment ID: I20220812002996 |
| Provider Name | Jeffrey A Sordahl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316241417 PECOS PAC ID: 3577917673 Enrollment ID: I20230922002751 |
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