NPIMap

Organization Active NPI

Mental Health Specialists

  • Clinical Social Worker
  • Chubbuck, ID
National Provider Identifier
1548585458
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MENTAL HEALTH SPECIALISTS
Practice address
210 W Burnside Ave
Suite a
Chubbuck, ID 83202-4916
Phone
(208) 238-9000
Fax
(208) 238-9002
NPI assigned
Apr 2, 2010
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Mr. Richard J Boyce, LCSWNPI 1336309319
Title
Director
Phone
(208) 238-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X Primary
Child & Adolescent Psychiatry Physician 2084P0804X
Physician Assistant 363A00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

210 W Burnside Ave
Suite a
Chubbuck, ID 83202-4916

Mailing address

210 W Burnside Ave
Suite a
Chubbuck, ID 83202-4916
Phone (208) 238-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160802003169 ID Part B Supplier - Clinic/Group Practice 1658665427 Receives reassigned benefits from 16 practitioners
Practice locations: Pocatello, ID

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Specialist2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

210 W Burnside Ave
Ste A
Pocatello, ID 83202
Phone (208) 238-9000

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1548585458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE",
            "address_2": "SUITE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-238-9000",
            "fax_number": "208-238-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE",
            "address_2": "SUITE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-238-9000",
            "fax_number": "208-238-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-02",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "BOYCE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-238-9000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.