State Avenue Offices

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

STATE AVENUE OFFICES

Practice address

39 E State Ave
Meridian, ID 83642-2342

Phone

(208) 994-3599

Fax

(208) 473-2206

NPI assigned

Aug 2, 2012

Organization subpart

No

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

Authorized official

Name

Camilla J Cafferty, LCPC

Title

Owner

Phone

(208) 994-3599

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1821344367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 E STATE AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422342",
            "telephone_number": "208-994-3599",
            "fax_number": "208-473-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 E STATE AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422342",
            "telephone_number": "208-994-3599",
            "fax_number": "208-473-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE AVENUE OFFICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "CAFFERTY",
        "authorized_official_first_name": "CAMILLA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-994-3599",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Stanley, LPC
• Taylor Stansbury, MS CF-SLP
• Star Anesthesia LLC
• Elliot Starcevich, OTR/L
• Taylor Victoria Starr, DO
• Janell Stears
• Zachary Stears
• Ryan Steed, CRNA
• Garrett Steel
• Cambria Jordan Steffler, RD

• Adult Mental Health Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Adult Mental Health Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.