NPIMap

Organization Active NPI

Psychological Service Associates

  • Clinical Psychologist
  • Idaho Falls, ID
National Provider Identifier
1871672840
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY-386 Issued in ID
Legal business name
PSYCHOLOGICAL SERVICE ASSOCIATES
Practice address
2235 E 25TH St
Suite 290
Idaho Falls, ID 83404-7519
Phone
(208) 525-2090
Fax
(208) 525-2662
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Howard K Harper, PHD
Title
Owner
Phone
(208) 552-0490

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY-386 ID Primary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X LMFT-2661 ID

Addresses

Primary practice location

2235 E 25TH St
Suite 290
Idaho Falls, ID 83404-7519

Mailing address

PO Box 3480
Idaho Falls, ID 83403-3480
Phone (208) 525-2090

Other identifiers 1

IdentifierTypeStateIssuer
806472900MedicaidID

National Provider Directory

National Provider Directory

Locations

2235 E 25th St
#290
Idaho Falls, ID 83404
Phone (208) 552-0490

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1871672840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3480",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834033480",
            "telephone_number": "208-525-2090",
            "fax_number": "208-525-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E 25TH ST",
            "address_2": "SUITE 290",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047519",
            "telephone_number": "208-525-2090",
            "fax_number": "208-525-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-552-0490",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-386",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-2661",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806472900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.