Active NPI
Bethany D. Henry, MED
- School Psychologist
- Grangeville, ID
National Provider Identifier
1104757988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 741464768
- Practice address
- 714 Jefferson Ave
Grangeville, ID 83530-1545 - Phone
- (208) 451-3632
- NPI assigned
- May 28, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 741464768 | ID | Primary |
Addresses
Primary practice location
714 Jefferson Ave
Grangeville, ID 83530-1545
Mailing address
714 Jefferson Ave
Grangeville, ID 83530-1545
Phone (208) 451-3632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 741464768 | ID | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1104757988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 JEFFERSON AVE",
"city": "GRANGEVILLE",
"state": "ID",
"postal_code": "835301545",
"telephone_number": "208-451-3632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 JEFFERSON AVE",
"city": "GRANGEVILLE",
"state": "ID",
"postal_code": "835301545",
"telephone_number": "208-451-3632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "BETHANY",
"middle_name": "D.",
"credential": "MED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-28",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "ID",
"license": "741464768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grangeville, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.