Northside Counseling and Rehab

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NORTHSIDE COUNSELING AND REHAB

Practice address

801 N Lincoln Ave
Jerome, ID 83338-1853

Phone

(208) 731-5750

NPI assigned

Nov 28, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Marylin Eacker, LSWNPI 1063667319

Title

Managing Member

Phone

(208) 731-5750

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.

• Marylin Eacker, LSW

  • Social Worker
  • Jerome, ID
  • NPI 1063667319
  NPD (past) Authorized official

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

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227830400000",
    "number": "1336394683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381853",
            "telephone_number": "208-731-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381853",
            "telephone_number": "208-731-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE COUNSELING AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-28",
        "last_updated": "2008-11-28",
        "status": "A",
        "authorized_official_last_name": "EACKER",
        "authorized_official_first_name": "MARYLIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "208-731-5750",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Ann Moore, BSW
• Danielle Myers
• Gregory Nelsen
• Next Mission Counseling and Consulting PLLC
• North Canyon Medical Center, Inc
• Ashlynn RS Norton
• Margaret M Oveson, SLP CF
• Darlena Owens
• Samuel C Page, DMD
• Jeffrey Ryan Palmer, DDS

• Community/Behavioral Health Agency in Jerome, ID
• Providers in Jerome, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2008; 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.