IDAHO STATE UNIVERSITY NPI 1811595929

NPI Information

NPI: 1811595929
Provider Name: IDAHO STATE UNIVERSITY
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1400 E TERRY DR BLDG 63
POCATELLO, ID
ZIP 83209
Phone: (208) 240-1690
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IDAHO STATE UNIVERSITY is a mental health counselor in Pocatello, ID. IDAHO STATE UNIVERSITY NPI is 1811595929. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1400 E TERRY DR BLDG 63
POCATELLO, ID
ZIP 83209-001
Phone: (208) 240-1690

The provider's authorized official is Cynthia Lee Rock .
The authorized official title is Clinics Director Of Operations and has the following contact phone number (208) 373-1743.

The enumeration date for this NPI number is 10/12/2020 and was last updated on 10/12/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

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

NPI Synchronization or Removal

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