Golder Enterprises LLC,

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMSW-32292 Issued in ID

Legal business name

GOLDER ENTERPRISES LLC,

Doing business as

Momentum Mental and Behavioral Health

Practice address

3867 E 12 N Ste 4
Rigby, ID 83442-4715

Phone

(208) 754-0911

Fax

(208) 228-0332

NPI assigned

Feb 1, 2016

Last updated

Feb 1, 2016By 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

Marcus Boyd Older, LMSW

Title

Owner

Phone

(208) 201-8881

Specialties & licenses 3

Addresses

Other names 1

• Momentum Mental and Behavioral Health Doing business as

Locations

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1639537012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3867 E 12 N STE 4",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834424715",
            "telephone_number": "208-754-0911",
            "fax_number": "298-228-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3867 E 12 N STE 4",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834424715",
            "telephone_number": "208-754-0911",
            "fax_number": "208-228-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDER ENTERPRISES LLC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "OLDER",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-201-8881",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "ID",
            "license": "LMSW-32292",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-32292",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": "LMSW-32292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Momentum Mental and Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Rigby, ID
• Providers in Rigby, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.