Eartherapy

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

LCPC-3187 Issued in ID

Legal business name

EARTHERAPY

Practice address

354 W Sunnyside Rd
Suite D
Idaho Falls, ID 83402-4644

Phone

(208) 528-6853

Fax

(208) 528-6888

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Stephanie Ann Schoen-Orr, LCPC

Title

Owner

Phone

(208) 528-6853

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1154639714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 W SUNNYSIDE RD",
            "address_2": "SUITE D",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024644",
            "telephone_number": "208-528-6853",
            "fax_number": "208-528-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 W SUNNYSIDE RD",
            "address_2": "SUITE D",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024644",
            "telephone_number": "208-528-6853",
            "fax_number": "208-528-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "SCHOEN-ORR",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-528-6853",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "ID",
            "license": "LCPC-3187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Adolescent and Children Mental Health Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.