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BRANNON & BRANNON PSYCHOLOGICAL SERVICES PA NPI 1023141116


NPI Information

NPI: 1023141116
Provider Name: BRANNON & BRANNON PSYCHOLOGICAL SERVICES PA
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
534 TREJO STREET
SUITE 100
REXBURG, ID
ZIP 83440
Phone: (208) 356-3776
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BRANNON & BRANNON PSYCHOLOGICAL SERVICES PA is an adult mental health clinic center in Rexburg, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. BRANNON & BRANNON PSYCHOLOGICAL SERVICES PA NPI is 1023141116. The provider is registered as an organization entity type.

The provider's business location address is:

534 TREJO STREET
SUITE 100
REXBURG, ID
ZIP 83440
Phone: (208) 356-3776
Fax: (208) 356-9498

The provider's authorized official is James M Brannon .
The authorized official title is Secretary and has the following contact phone number (208) 356-3776.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 10/29/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
2261QM0850XClinic/CenterAdult Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1002803600MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.