NPIMap

Organization Active NPI

Michael J. Eisenbeiss, Sr. Dba Boise Psychological Services

  • Clinical Psychologist
  • Boise, ID
National Provider Identifier
1851454250
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY57 Issued in ID
Legal business name
MICHAEL J. EISENBEISS, SR. DBA BOISE PSYCHOLOGICAL SERVICES
Practice address
315 North Allumbaugh Street
Boise, ID 83704
Phone
(208) 376-3546
Fax
(208) 376-9792
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Dr. Michael J Eisenbeiss Sr., PHDNPI 1740343235
Title
Owner
Phone
(208) 376-3546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY57 ID Primary

Addresses

Primary practice location

315 North Allumbaugh Street
Boise, ID 83704

Mailing address

315 North Allumbaugh Street
Boise, ID 83704
Phone (208) 376-3546

National Provider Directory

National Provider Directory

Locations

315 N Allumbaugh St
Boise, ID 83704
Phone (208) 323-2847

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1851454250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 NORTH ALLUMBAUGH STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-376-3546",
            "fax_number": "208-376-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 NORTH ALLUMBAUGH STREET",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-376-3546",
            "fax_number": "208-376-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. EISENBEISS, SR. DBA BOISE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "EISENBEISS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-376-3546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.