Pacific Mind Institute

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PACIFIC MIND INSTITUTE

Practice address

2596 N Stokesberry PL Ste 165
Meridian, ID 83646-6281

Phone

(208) 631-0843

Fax

(208) 906-0807

NPI assigned

Sep 20, 2017

Organization subpart

No

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

Authorized official

Name

Erica Jane Van Leuven, LCPC

Title

Owner/Clinician

Phone

(208) 631-0843

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346759495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2596 N STOKESBERRY PL STE 165",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466281",
            "telephone_number": "208-631-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2596 N STOKESBERRY PL STE 165",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466281",
            "telephone_number": "208-631-0843",
            "fax_number": "208-906-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MIND INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VAN LEUVEN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "208-631-0843",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owens Medical PLLC
• P. Roman Burk DPM PC
• P. Roman Burk DPM PC
• Janet A Pace, LCSW
• Maximilian Miles Pacheco, DMD
• Pacific Northwest Counseling
• Sarah Pagano, CPM, LM
• Katherine Pages, PHARMD
• Ellen Connolly Paget, ARNP
• Michael Pahang, PMHNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Meridian, ID
• Providers in Meridian, ID by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.