Individual provider Active NPI

Shawn L Thurber, PHD

  • Marriage & Family Therapist
  • Idaho Falls, ID
National Provider Identifier
1457453789
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 3341 Issued in ID
Practice address
1675 Curlew Dr.
Idaho Falls, ID 83406
Phone
(208) 529-4300
Fax
(208) 529-1627
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT 3341 ID Primary

Addresses

Primary practice location

1675 Curlew Dr.
Idaho Falls, ID 83406

Mailing address

4090 Willow Canyon Dr
Ammon, ID 83406-6899
Phone (208) 523-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104001603 ID Practitioner - Marriage and Family Therapist 6305297383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LMFT 3341IDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Human Dynamics and Diagnostics, LLC CurrentSince Jan 1, 2024 Accepting new patients
Neuvoa Counseling & Associates, LLC Past Accepting new patients

Locations

2267 Teton Plz
Idaho Falls, ID 83404
Phone (208) 522-0140

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457453789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 WILLOW CANYON DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066899",
            "telephone_number": "208-523-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DR.",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-529-4300",
            "fax_number": "208-529-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURBER",
        "first_name": "SHAWN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT 3341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.