Individual provider Active NPI

Sterling Don Andelin, PHD

  • Clinical Psychologist
  • Idaho Falls, ID
National Provider Identifier
1457466260
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-111 Issued in ID
Practice address
2539 Channing Way Ste 120
Idaho Falls, ID 83404-7558
Phone
(208) 589-1013
Fax
(208) 523-5991
NPI assigned
Aug 20, 2006
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY-111 ID Primary

Addresses

Primary practice location

2539 Channing Way Ste 120
Idaho Falls, ID 83404-7558

Mailing address

2539 Channing Way Ste 120
Idaho Falls, ID 83404-7558
Phone (208) 589-1013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • 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
I20080711000281 ID Practitioner - Clinical Psychologist 2466524178 Practice locations: Idaho Falls, ID

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2539 Channing Way
Suite 120
Idaho Falls, ID 83404-7558
Phone (208) 589-1013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY-111IDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1457466260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 CHANNING WAY STE 120",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047558",
            "telephone_number": "208-589-1013",
            "fax_number": "208-523-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 CHANNING WAY STE 120",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047558",
            "telephone_number": "208-589-1013",
            "fax_number": "208-523-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDELIN",
        "first_name": "STERLING",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.