Active NPI
John L Christensen PHD PC
- Rehabilitation Counselor
- Pocatello, ID
National Provider Identifier
1245353440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- License
- PSY202148
- Legal business name
- JOHN L CHRISTENSEN PHD PC
- Doing business as
- Psychosocial Rehabilitation Specialists
- Practice address
- 500 S 11TH Ave
Suite 302
Pocatello, ID 83201 - Phone
- (208) 233-0150
- Fax
- (208) 233-0159
- NPI assigned
- Apr 10, 2007
- Organization subpart
- Yes
- Parent organization
- JOHN L CHRISTENSEN PHD PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nichole Christensen
- Title
- Secretary
- Phone
- (208) 234-1707
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | PSY202148 | ID | Primary |
| Community/Behavioral Health Agency | 251S00000X | PSY202148 | ID |
Addresses
Primary practice location
500 S 11TH Ave
Suite 302
Pocatello, ID 83201
Mailing address
13235 N Manning LN
Pocatello, ID 83202-5184
Phone (208) 233-0150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807691400 | Medicaid | ID |
Other names 1
- Psychosocial Rehabilitation Specialists
National Provider Directory
National Provider Directory- Part of
- John L Christensen PHD PC
Locations
500 S 11th Ave
Ste 302
Pocatello, ID 83201
Phone (208) 232-5902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1243382400000",
"number": "1245353440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13235 N MANNING LN",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832025184",
"telephone_number": "208-233-0150",
"fax_number": "208-233-0159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S 11TH AVE",
"address_2": "SUITE 302",
"city": "POCATELLO",
"state": "ID",
"postal_code": "83201",
"telephone_number": "208-233-0150",
"fax_number": "208-233-0159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHN L CHRISTENSEN PHD PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JOHN L CHRISTENSEN PHD PC",
"enumeration_date": "2007-04-10",
"last_updated": "2009-05-27",
"status": "A",
"authorized_official_last_name": "CHRISTENSEN",
"authorized_official_first_name": "NICHOLE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "208-234-1707"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Rehabilitation Counselor",
"state": "ID",
"license": "PSY202148",
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "ID",
"license": "PSY202148",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807691400",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Psychosocial Rehabilitation Specialists",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.