Jacob Comstock
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Blackfoot, ID
NPI 1386039675 · NPPES record last updated Sep 28, 2015
Key facts
- NPI
- 1386039675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LCSW-34156 (ID)
- Practice address
- 412 W Pacific St
Blackfoot, ID 83221-1726 - Phone
- (208) 201-1743
- NPI assigned
- Apr 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health West Inc
Practice addresses (Care Compare)
1001 N 7TH Ave
Suite 135
Pocatello, ID 83201-5761
Phone (208) 234-2489
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151104002900 | ID | Practitioner - Clinical Social Worker | 9537479423 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health West, Inc. | Current | Accepting new patients | |
| Health West, Inc. | Current |
Accepting new patients | |
| Deer Oaks Mental Health Associates PC | Current |
Accepting new patients | |
| Health West, Inc. | Current | Accepting new patients | |
| Health West, Inc. | Current |
Accepting new patients | |
| Health West, Inc. | Current | Accepting new patients |
Locations
823 Reed St
American Falls, ID 83211
Phone (208) 226-2822
840 E Elva St
Idaho Falls, ID 83401
Phone (208) 523-4795
2609 Sunnybrook Dr
Nampa, ID 83686
Phone (208) 467-7298
1000 N 8th Ave
Pocatello, ID 83201
Phone (208) 232-6260
465 Memorial Dr
Pocatello, ID 83201
Phone (208) 234-4700
1001 N 7th Ave
Ste 135
Pocatello, ID 83201
Phone (208) 234-2489
500 S 11th Ave
Ste 204
Pocatello, ID 83201
Phone (208) 232-1443
655 S 4th E
Ste 600
Preston, ID 83263
Phone 20823278621122
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCSW-34156 | ID | Yes |
Addresses
Primary practice location
412 W Pacific St
Blackfoot, ID 83221-1726
Mailing address
2420E 25TH St
Idaho Falls, ID 83404-7549
Phone (208) 542-1026
Other providers in Blackfoot, ID
- Comfort Home Care
- Community Council of Idaho, Inc
- Community Council of Idaho, Inc.
- Community Council of Idaho, Inc.
- Complete Family Eye Care, PA
- Thomas Ray Cook
- Stacy Cooper
- Alan E Crandall
- Nicole Criddle
- Crimson Sky Therapy PLLC
All providers in Blackfoot, ID · Addiction (Substance Use Disorder) Counselor in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.