NPI age
19 years
Enumerated 2007-03-09
● Active Type 2 · Organization
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc is 1 of 326 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Axford
Program Manager
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 326 active clinic/center providers in Idaho.
NPI age
19 years
↑ 14 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
421 Memorial Dr
Pocatello, ID 832014008
Mailing address
421 Memorial Dr
Pocatello, ID 832014008
Authorized official
Ed Axford
Program Manager
📞 2082347900
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Richard Bloxham, LSW Social Worker NPI 1588026553
- Linda Carter, MD Psychiatry & Neurology NPI 1912046525
- Sydney Chapman, BA Developmental Therapist NPI 1295317543
- William Eckersell, LCPC Counselor NPI 1346602430
- Karen Gonzalez, LMSW Social Worker NPI 1568014066
- Danson Hall, DPT Physical Therapist NPI 1144723123
- Kyle Hanson, LPC Counselor NPI 1942656020
- Braun Inslee, LMHC, LPC Counselor NPI 1013564103
- Rebecca Klingler, PMHNP Nurse Practitioner NPI 1235624834
- Tonja Knapp, RN Registered Nurse NPI 1487016218
- Idelia Labra Developmental Therapist NPI 1508226408
- Anne Miller, LCSW Social Worker NPI 1164884052
- Rachel Miller Developmental Therapist NPI 1003545161
- Michele Osmond, LCPC Counselor NPI 1053773952
- Bailey Rainey Developmental Therapist NPI 1548756869
- Andrea Rausch, BA-ECSE Developmental Therapist NPI 1467812685
- Keri Smith Developmental Therapist NPI 1619631249
- Jessica Sturman Developmental Therapist NPI 1093175218
- Jordan Thomas, LPC Counselor NPI 1578351045
- Kelley Tillotson, R.N., BSN Registered Nurse NPI 1346602091
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | HW108 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010019235 | BLUE SHIELD |
| 05 (ID) | 0028411 |
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
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