| |
1363 Fillmore St Twin Falls ID 83301-3392 | |
(208) 736-7090 | |
(208) 736-7089 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1363 Fillmore St, Twin Falls, Idaho |
Authorized Official Name and Position | Nyla M Jensen (ADMINISTRATOR) |
Authorized Official Contact | 2087367090 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1363 Fillmore St Twin Falls ID 83301-3392 Ph: (208) 736-7090 | 1363 Fillmore St Twin Falls ID 83301-3392 Ph: (208) 736-7090 |
NPI Number | 1386914505 |
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Provider Enumeration Date | 01/04/2012 |
Last Update Date | 05/23/2014 |
Medicare PECOS PAC ID | 8921257130 |
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Medicare Enrollment ID | O20121003000722 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386914505 | NPI | - | NPPES |
1235457565 | Medicaid | ID |
Provider Name | Mark Dalton Ellis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1336401710 PECOS PAC ID: 6709005598 Enrollment ID: I20140918000102 |
Provider Name | Kristan Nichole French |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1073171286 PECOS PAC ID: 4486036118 Enrollment ID: I20220727004014 |
Provider Name | Mark Andrew Chappel |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1699370692 PECOS PAC ID: 2567813553 Enrollment ID: I20240103003514 |
Provider Name | Kristina Marie Loder |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497347694 PECOS PAC ID: 5496106189 Enrollment ID: I20240106000947 |
Provider Name | Mark Allen Gritton |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1205080660 PECOS PAC ID: 7911156120 Enrollment ID: I20240111001701 |
Provider Name | Erin Lee Webb |
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Provider Type | Practitioner - Other (non-physician) |
Provider Identifiers | NPI Number: 1174159792 PECOS PAC ID: 3779934930 Enrollment ID: I20240111004296 |
Provider Name | Jennie Rebecca Fullmer |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1720433600 PECOS PAC ID: 5294984407 Enrollment ID: I20240116002831 |
Provider Name | Adan Gerardo Saucedo Gonzalez |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1811677230 PECOS PAC ID: 0244682177 Enrollment ID: I20240117000256 |
Provider Name | Melissa Sue Uhl |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1598109266 PECOS PAC ID: 8224481239 Enrollment ID: I20240125004153 |
Provider Name | Amadea Alma De Groot |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1326786385 PECOS PAC ID: 3577907435 Enrollment ID: I20240219002676 |
Provider Name | Allison Welch |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1831847755 PECOS PAC ID: 0345684130 Enrollment ID: I20240220003866 |
Provider Name | Steven V Parker |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1336536937 PECOS PAC ID: 4880033158 Enrollment ID: I20240418004349 |
Flourish Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1772 Maplewood Dr, Twin Falls, ID 83301 Phone: 208-731-5747 | |
Positive Connections Plus, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1373 Fillmore St, Twin Falls, ID 83301 Phone: 208-737-9999 Fax: 208-736-4400 | |
River Wellness Center Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 139 River Vista Pl Ste 106c, Twin Falls, ID 83301 Phone: 208-731-0664 | |
Community Support Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 336 Main Ave S, Twin Falls, ID 83301 Phone: 208-737-0777 Fax: 208-734-5470 |