NPIMap

Organization Active NPI

Mental Health Specialists

  • Social Worker
  • Chubbuck, ID
National Provider Identifier
1558798108
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
31976 Issued in ID
Legal business name
MENTAL HEALTH SPECIALISTS
Practice address
210 W Burnside Ave
Chubbuck, ID 83202-4916
Phone
(208) 238-9000
Fax
(208) 238-9002
NPI assigned
Sep 27, 2013
Last updated
Sep 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
Mr. Ric Boyce, LMSW
Title
Ceo
Phone
(208) 238-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 31976 ID Primary

Addresses

Primary practice location

210 W Burnside Ave
Chubbuck, ID 83202-4916

Mailing address

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

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
Pocatello, ID 83202
Phone (208) 238-9000

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1558798108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE",
            "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",
            "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": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "BOYCE",
        "authorized_official_first_name": "RIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-238-9000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "31976",
            "primary": true
        }
    ],
    "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 Sep 27, 2013; 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.