| Mountain View Behavioral Health, Llc | |
|
6213 N Cloverdale Rd Ste 115 Boise ID 83713-4972 | |
| (208) 322-5354 | |
| Not Available |
| Full Name | Mountain View Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6213 N Cloverdale Rd Ste 115, Boise, Idaho |
| Authorized Official Name and Position | Tatiana M. Weeks (CREDENTIALING) |
| Authorized Official Contact | 2083225354 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain View Behavioral Health, Llc 3138 W Mirage Ct Meridian ID 83646-4127 Ph: (208) 861-6021 | Mountain View Behavioral Health, Llc 6213 N Cloverdale Rd Ste 115 Boise ID 83713-4972 Ph: (208) 322-5354 |
| NPI Number | 1992035364 |
|---|---|
| Provider Enumeration Date | 01/07/2010 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/29/2024 |
| Medicare PECOS PAC ID | 7315174059 |
|---|---|
| Medicare Enrollment ID | O20131230000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992035364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Stacey K Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497716476 PECOS PAC ID: 5193728939 Enrollment ID: I20060816000211 |
| Provider Name | Julie Schrader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932303104 PECOS PAC ID: 1557498185 Enrollment ID: I20100429000911 |
| Provider Name | Michelle Chin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649645938 PECOS PAC ID: 9133421423 Enrollment ID: I20160104001128 |
| Provider Name | Margaret Gordon Zipf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154477321 PECOS PAC ID: 8921399569 Enrollment ID: I20161019002448 |
| Provider Name | Kyle Joseph Ronnau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326584640 PECOS PAC ID: 9133492986 Enrollment ID: I20170830002027 |
| Provider Name | Sarah M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346768330 PECOS PAC ID: 9335414135 Enrollment ID: I20191028001804 |
| Provider Name | Jenny M Pinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407102056 PECOS PAC ID: 3971598251 Enrollment ID: I20210817003892 |
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