Northern Star Healing, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

NORTHERN STAR HEALING, PLLC

Practice address

1530 Fairway Street
Mountain Home, ID 83647

Phone

(208) 794-0048

Fax

(855) 471-0759

NPI assigned

Apr 21, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daniel Eli Novak, PHD, LCAC, LCSW

Title

Owner

Phone

(208) 794-0048

Specialties & licenses 1

Addresses

Other names 1

• Northern Star Healing, PLLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1003497975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 FAIRWAY STREET",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "83647",
            "telephone_number": "208-794-0048",
            "fax_number": "855-471-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 FAIRWAY STREET",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "83647",
            "telephone_number": "208-794-0048",
            "fax_number": "855-471-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN STAR HEALING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ELI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-794-0048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LCAC, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Star Healing, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thanh-Truc Nguyen
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• Jonathan Paul Norris, O.D.
• North Canyon Mountain Home Clinic
• Jason Dale Oakes, FNP-C
• Kory Dell Olaveson, PHARMD
• Randi Ortega, LPN
• Emma Orthel, LCP
• Katie A Owens

• Clinical Social Worker in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.