Michael Brinker, PSYD
Individual provider Active NPI Clinical Psychologist · Meridian, ID
NPI 1053679985 · NPPES record last updated Aug 15, 2017
Key facts
- NPI
- 1053679985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 202751 (ID)
- Practice address
- 2076 S Eagle Rd
Meridian, ID 83642-6707 - Phone
- (289) 775-4515
- NPI assigned
- Apr 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202751 | ID | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Turning Point Center for Youth and Family Development Inc. | Past | Accepting new patients | |
| Northwest Neurobehavioral Health PLLC | Clinical | Past | Accepting new patients |
| Turning Point Center for Youth and Family Development, Inc. | Past | Accepting new patients | |
| Turning Point Center for Youth & Development, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 202751 | ID | Yes |
Addresses
Primary practice location
2076 S Eagle Rd
Meridian, ID 83642-6707
Mailing address
711 West Village Lane
Boise, ID 83702
Phone (303) 681-8712
Other providers in Meridian, ID
- Bright Hope Therapy LLC
- Lisa M Bright
- Brighthaven Supported Living LLC
- Pamela Kay Brill
- Wesley B Brimhall
- McKenna Anne Brinkman
- Brinton Anesthesia Group PLLC
- Clark Brinton
- Carly Broadhead
- Megan Lee Brock
All providers in Meridian, ID · Clinical Psychologist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.