Jennifer Leslie Gallup, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

7051353 Issued in ID

Practice address

1951 Bench Rd Ste G
Pocatello, ID 83201-2073

Phone

(208) 760-2144

Fax

(208) 269-1486

NPI assigned

Oct 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Total Spectrum Mental Health Services

  • Clinical Child & Adolescent Psychologist
  • Pocatello, ID
  • NPI 1306726674
  NPD Authorized official
• Full Spectrum Therapy

  • Clinical Child & Adolescent Psychologist
  • Pocatello, ID
  • NPI 1790668069
  NPD
• Adolpho Enterprise LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
  • NPI 1063340586
  NPD (past)
• Full Spectrum Therapy

  • Psychologist
  • Pocatello, ID
  • NPI 1700759255
  NPD (past)

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1609648807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 BENCH RD STE G",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012073",
            "telephone_number": "208-760-2144",
            "fax_number": "208-269-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 BENCH RD STE G",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012073",
            "telephone_number": "208-760-2144",
            "fax_number": "208-269-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "JENNIFER",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ID",
            "license": "7051353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul A Gagnon, D.M.D.
• Hannah Marie Galbreth, PHARM.D
• Deanna Lynn Gallagher, MARRIAGE & FAMILY TH
• Evelyn Galloway, LICENSED
• Douglas R Gallup, LCPC
• Danny Ray Gandy Jr.
• Esmeralda Garcia, LPC
• Jolyn Garcia
• Maria Guadalupe Garcia
• Rachel Mae Garcia, LPC, NCC

• All providers in Pocatello, ID
• Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.