Individual provider Active NPI

Jodi Lynn Dennett

  • Mental Health Counselor
  • Ammon, ID
National Provider Identifier
1033908306
Registry record updated May 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2705 E 17TH St
Ammon, ID 83406-6669
Phone
(208) 346-7500
NPI assigned
May 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2705 E 17TH St
Ammon, ID 83406-6669

Mailing address

2705 E 17TH St
Ammon, ID 83406-6669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250804002181 ID Practitioner - Mental Health Counselor 5092223743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Health Clinic Mental Health CurrentSince Jun 20, 2025 Accepting new patients

Locations

2705 E 17th St
Ammon, ID 83406

725 S Woodruff Ave
Ste 101
Idaho Falls, ID 83401

500 S 11th Ave
Ste 203
Pocatello, ID 83201
Phone (208) 232-5902

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746230400000",
    "number": "1033908306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066669",
            "telephone_number": "208-346-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNETT",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-03",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.