K2 Fmily Partnership

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

K2 FMILY PARTNERSHIP

Practice address

5723 E Dodd Rd
Hayden Lake, ID 83835-9376

Phone

(208) 699-1704

NPI assigned

Oct 16, 2017

Last updated

Oct 16, 2017By 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

Katherine WacholzNPI 1366079733

Title

Clinical Supervisor

Phone

(208) 699-1704

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Katherine Wacholz

  • Behavior Analyst
  • Hayden, ID
  • NPI 1366079733
  NPD (past) Authorized official

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1306357439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5723 E DODD RD",
            "city": "HAYDEN LAKE",
            "state": "ID",
            "postal_code": "838359376",
            "telephone_number": "208-699-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5723 E DODD RD",
            "city": "HAYDEN LAKE",
            "state": "ID",
            "postal_code": "838359376",
            "telephone_number": "208-699-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K2 FMILY PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "WACHOLZ",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "208-699-1704"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon N Cox, LMT, LE
• Paula Ione Dahlen, F-NP
• Tracy Jo Ellis, LMT
• Charles G Graves III, M.D.
• Integrated Interventions LLC
• Katherine Wacholz Agency
• Bruce Kitchen, LMP
• See Yan Lau, PHARM.D
• Deborah Jean Long, A.R.N.P.
• Betty J Magnus, LCPC

• Behavior Analyst in Hayden Lake, ID
• Providers in Hayden Lake, ID by specialty
• Behavior Analyst in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.