Psychological Preventative Health PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PSYCHOLOGICAL PREVENTATIVE HEALTH PLLC

Practice address

2300 N Yellowstone Hwy Ste 207
Idaho Falls, ID 83401-1652

Phone

(801) 719-7737

Fax

(888) 887-9784

NPI assigned

Apr 1, 2020

Last updated

Feb 21, 2022By 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

Melanie Richarson, LCSW

Title

Owner

Phone

(801) 719-7737

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, UT2 enrollments

Enrollment records 2

Locations

Practitioners 30

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.

• Brooke Chambers

  • Clinical Social Worker
  • Ogden, UT
  • NPI 1396289021
  Medicare reassignment Care Compare group NPD
• Matthew Edward Feinauer

  • Clinical Social Worker
  • Murray, UT
  • NPI 1457900680
  Medicare reassignment Care Compare group NPD
• Stacee Goff

  • Counselor
  • Ogden, UT
  • NPI 1881479244
  Medicare reassignment Care Compare group NPD
• Charise Hulse

  • Social Worker
  • Ogden, UT
  • NPI 1851791164
  Medicare reassignment Care Compare group NPD
• Kayla J Lesmeister, ACMHC

  • Mental Health Counselor
  • Ogden, UT
  • NPI 1740972504
  Medicare reassignment Care Compare group NPD
• Victoria A Nelson

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1689345415
  Medicare reassignment Care Compare group NPD
• Tamra Denton Phelps

  • Professional Counselor
  • Tremonton, UT
  • NPI 1043764822
  Medicare reassignment Care Compare group NPD
• Ashlie Kate Rasband, CSW

  • Clinical Social Worker
  • Ogden, UT
  • NPI 1174303747
  Medicare reassignment Care Compare group NPD
• Melanie Richardson, LCSW

  • Clinical Social Worker
  • Kaysville, UT
  • NPI 1013328103

  ID

  Medicare reassignment Care Compare group NPD
• Christopher Schulze

  • Clinical Social Worker
  • Layton, UT
  • NPI 1821500943
  Medicare reassignment Care Compare group NPD
• Karlinda Smith

  • Social Worker
  • Ogden, UT
  • NPI 1932752144
  Medicare reassignment Care Compare group NPD
• Lakyn Smith

  • Social Worker
  • Ogden, UT
  • NPI 1124779103
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1649808767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2184 CHANNING WAY # 157",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048034",
            "telephone_number": "208-709-3925",
            "fax_number": "888-887-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N YELLOWSTONE HWY STE 207",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834011652",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4933 S 1500 W",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "UT",
            "postal_code": "844057175",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2317 N Hill Field Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840414782",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2363 N Hill Field Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840416958",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1188 W Sportsplex Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Kaysville",
            "state": "UT",
            "postal_code": "840376817",
            "country_code": "US",
            "telephone_number": "801-719-7737",
            "fax_number": "888-887-9784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHOLOGICAL PREVENTATIVE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "RICHARSON",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-719-7737",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wade Kelly Price, D.C.
• Kevin Prier
• Pro Heal Hyperbarics & Wound Care
• Progress Therapy LLC
• Proventures LLC (Side by Side Family Services)
• Psychological Service Associates
• Psychology Center of Idaho Falls
• PT Medical LLC
• Katherine Ann Puckett, BS, SIT
• Zachary Lynn Pugmire, DPT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.