Northwest Neurobehavioral Health PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY202444 Issued in ID

Legal business name

NORTHWEST NEUROBEHAVIORAL HEALTH PLLC

Practice address

6003 Overland Rd Ste 301
Boise, ID 83709-3077

Phone

(208) 672-8699

Fax

(208) 672-9308

NPI assigned

Dec 2, 2008

Last updated

Dec 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Trevor Allen Hall, PSYD

Title

President

Phone

(208) 672-8699

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1518102797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 OVERLAND RD STE 301",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837093077",
            "telephone_number": "208-672-8699",
            "fax_number": "208-672-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 OVERLAND RD STE 301",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837093077",
            "telephone_number": "208-672-8699",
            "fax_number": "208-672-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST NEUROBEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-672-8699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY202444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI",
            "identifier": "1306914643",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.