NPIMap

Organization Active NPI

Snake River Counseling Center LLC

  • Adult Mental Health Clinic/Center
  • Idaho Falls, ID
National Provider Identifier
1235401522
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SNAKE RIVER COUNSELING CENTER LLC
Practice address
2635 Channing Way
Suite B
Idaho Falls, ID 83404-7518
Phone
(208) 552-0490
Fax
(208) 552-2518
NPI assigned
Feb 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Authorized official

Name
Juli Popejoy
Title
Billing Manager
Phone
(208) 525-2090

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2635 Channing Way
Suite B
Idaho Falls, ID 83404-7518

Mailing address

2635 Channing Way
Suite B
Idaho Falls, ID 83404-7518
Phone (208) 552-0490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120410000327 ID Part B Supplier - Clinic/Group Practice 3779744263 Receives reassigned benefits from 1 practitioner
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Locations

2635 Channing Way
#B
Idaho Falls, ID 83404
Phone (208) 552-0490

2235 E 25th St
Ste 290
Idaho Falls, ID 83404
Phone (208) 552-0490

1970 E 17th St
Ste 121
Idaho Falls, ID 83404
Phone (208) 552-0490

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1235401522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 CHANNING WAY",
            "address_2": "SUITE B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047518",
            "telephone_number": "208-552-0490",
            "fax_number": "208-552-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 CHANNING WAY",
            "address_2": "SUITE B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047518",
            "telephone_number": "208-552-0490",
            "fax_number": "208-552-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNAKE RIVER COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "POPEJOY",
        "authorized_official_first_name": "JULI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "208-525-2090"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.