| Youth And Family Renewal Services | |
|
2935 Rollandet St Idaho Falls ID 83402-4654 | |
| (208) 542-2905 | |
| (208) 522-2427 |
| Full Name | Youth And Family Renewal Services |
|---|---|
| Speciality | Counselor |
| Location | 2935 Rollandet St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Sheila Kellogg (ADMINISTRATOR) |
| Authorized Official Contact | 2086527461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth And Family Renewal Services Po Box 838 700 N. 2nd Street Ashton ID 83420-0838 Ph: (208) 652-7461 | Youth And Family Renewal Services 2935 Rollandet St Idaho Falls ID 83402-4654 Ph: (208) 542-2905 |
| NPI Number | 1003907163 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7719898873 |
|---|---|
| Medicare Enrollment ID | O20080529000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003907163 | NPI | - | NPPES |
| 805100400 | Medicaid | ID | |
| 807641700 | Medicaid | ID | |
| 807195500 | Medicaid | ID | |
| 807361800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Stephen J Cheyne |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346391513 PECOS PAC ID: 7012994452 Enrollment ID: I20040702000414 |
| Provider Name | Craig J Denny |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720071319 PECOS PAC ID: 1456319300 Enrollment ID: I20050412001214 |
| Provider Name | Shon L Shuldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326212002 PECOS PAC ID: 4486724721 Enrollment ID: I20080529000560 |
| Provider Name | Kelly Marie Mcmurtrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356656441 PECOS PAC ID: 6103143441 Enrollment ID: I20150325000503 |
| Provider Name | Jamie L Gudmunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669853719 PECOS PAC ID: 3971816448 Enrollment ID: I20150714000351 |
| Provider Name | David Paul Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417443631 PECOS PAC ID: 6507118577 Enrollment ID: I20181003001014 |
| Provider Name | Tina Scoggins |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1689037129 PECOS PAC ID: 3375882988 Enrollment ID: I20191030002281 |
| Provider Name | Cathy Renee Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881221091 PECOS PAC ID: 0547677205 Enrollment ID: I20210324001676 |
| Provider Name | Alice Joan Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528799103 PECOS PAC ID: 0840668042 Enrollment ID: I20221118001942 |
| Provider Name | Janice Guillot Jeansonne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609203793 PECOS PAC ID: 9638306996 Enrollment ID: I20230503000803 |
| Provider Name | David Strong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457791550 PECOS PAC ID: 0749633972 Enrollment ID: I20240124002027 |
| Provider Name | Angela Marie Fletcher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336327857 PECOS PAC ID: 7416390323 Enrollment ID: I20240207004326 |
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 | |
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 | |
Integrated Family & Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3355 S Holmes Ave, Idaho Falls, ID 83404 Phone: 208-523-2080 Fax: 208-523-2799 | |
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 |