Dr. Paula M. Nordstrom, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-303 Issued in ID

Legal business name

DR. PAULA M. NORDSTROM, LLC

Practice address

3904 E Flamingo Avenue
200
Nampa, ID 83687-3102

Phone

(208) 089-1888

Fax

(208) 839-2301

NPI assigned

Jan 25, 2012

Last updated

Jul 29, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paula Michelle Nordstrom, PH.D.

Title

Owner

Phone

(208) 989-1686

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Virginia Spackman, M.ED, LCPC

  • Mental Health Counselor
  • Nampa, ID
  • NPI 1932590221
  NPD
• Jessica Chilcott, LCSW

  • Clinical Social Worker
  • Nampa, ID
  • NPI 1104248194
  NPD (past)
• Jynnah Leigh Schwartzwolf, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, ID
  • NPI 1437622776
  NPD (past)

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1063783728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 E FLAMINGO AVENUE",
            "address_2": "200",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873102",
            "telephone_number": "208-089-1888",
            "fax_number": "208-839-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 E FLAMINGO AVENUE",
            "address_2": "200",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873102",
            "telephone_number": "208-089-1888",
            "fax_number": "208-839-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PAULA M. NORDSTROM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "NORDSTROM",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-989-1686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Aine Donohoe, PA
• Robert James Douglas, MD
• Samantha Jo Downing, CRM
• Melissa Dian Downs, RN
• Amanda Dozier, FNP-C
• Amanda Draper
• Christian Xavier Drayton
• Cheryl Driskell, RPH
• Dror Counseling
• Cline Duff

• Clinical Psychologist in Nampa, ID
• Providers in Nampa, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.