NPI age
6 years
Enumerated 2020-02-27
● Active Type 2 · Organization
Subpart
Telemental Health Link Llc
Telemental Health Link Llc is 1 of 374 nurse practitioner organizations in Idaho.
Primary specialty
Nurse Practitioner
Plus 1 secondary
Practice locations
3
2 secondary on file
Status
Active
No deactivations on record
Authorized official
Derivas
Ao
Last NPPES update
2024-02-07
Source: monthly bulk 2026-05
How this organization compares
Across 374 active nurse practitioner providers in Idaho.
NPI age
6 years
↑ 2 yr above median
Practice locations
3
2 secondary on file
Subspecialties
1
In the 34% of peers with subspecialties
NPI lifetime · 2020 → 2026
2020-02Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
4055 E Blueberry St
Meridian, ID 836428261
Mailing address
4055 E Blueberry St
Meridian, ID 836428261
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
5700 Harper Dr Ne Ste 210
Albuquerque, NM 871093541
Location 3
10173 Trailridge Dr
Shreveport, LA 711067651
Authorized official
Susan M Derivas, PMHNP-BC
Ao
📞 2087757418
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Susan Derivas, CNP Nurse Practitioner NPI 1851493829
- Anne Shields, FNP, CS P-MH Clinical Nurse Specialist NPI 1174626162
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
-
Clinic/CenterDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 396453OSMIND | CHANGE HEALTHCARE MASTER BILLING ID |
| 01 (NM) | 58322 | NURSING LICENSE |
| 01 (NM) | 58322 | NEW MEXICO APRN CNP LICENSE |
| 05 (ID) | 020837 | |
| 01 | 13961493 | CAQH ID |
| 01 (ID) | 64266 | NURSING LICENSE |
| 01 (LA) | 03962 | NURSING LICENSE |
| 01 | 1529234 | NCSBN ID |
| 01 | 0364158 | ANCC CERTIFICATION NO. |
| 01 (LA) | 363LP0808X | TAXONOMIES: NURSE PRACTITIONER PSYCH MENTAL HEALTH |
| 01 (LA) | P69441 | UPIN |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
TELEMENTAL HEALTH LINK - NM
-
Psychiatric Nurse Practitioner Services LLC
Practice context
Multi-provider organization. 2 individual providers on file at this primary address. Plus 2 secondary practice locations.
Subpart of Psychiatric Nurse Practitioner Services Llc.
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Request a quote →How to verify this organization
- 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.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.