Treasure Valley Neurotherapy LLC

Primary specialty

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

Legal business name

TREASURE VALLEY NEUROTHERAPY LLC

Practice address

1677 E Miles Ave Ste 100
Hayden Lake, ID 83835-9154

Phone

(208) 631-1089

NPI assigned

Oct 10, 2023

Organization subpart

No

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

Authorized official

Name

Sarah Jordan, MA, LCPC, LMHCNPI 1639333172

Title

Clinical Director

Phone

(208) 631-1089

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Jordan

  • Mental Health Counselor
  • Spokane Valley, WA
  • NPI 1639333172
  NPD Authorized official

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1508647025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 E SELTICE WAY # 334",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838547019",
            "telephone_number": "208-631-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 E MILES AVE STE 100",
            "city": "HAYDEN LAKE",
            "state": "ID",
            "postal_code": "838359154",
            "telephone_number": "208-631-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY NEUROTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "208-631-1089",
        "authorized_official_credential": "MA, LCPC, LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Jean Long, A.R.N.P.
• Betty J Magnus, LCPC
• Medical Consulting Services, LLC (Medical Consulting Services)
• Michael a. Bloom D.M.D. PLLC
• Renee Palmer, APRN, CNP
• Stanley Keith Wacholz, BS BIS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Hayden Lake, ID
• Providers in Hayden Lake, 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 Oct 10, 2023; 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.