STATE HOSPITAL SOUTH GROUP
NPI 1053615260
Psychologist in Blackfoot, ID

Active since January 03, 2011
700 E ALICE ST, BLACKFOOT, ID 83221(208) 785-8506(208) 785-8518 Get Directions Write a Review

NPPES record last updated: January 3, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About State Hospital South Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STATE HOSPITAL SOUTH GROUP (NPI 1053615260) is a healthcare organization registered as a psychologist in Blackfoot, Idaho and active in the NPI registry since January 2011. The organization lists Lorna B Colvin, Patient Account Specialist, as its authorized official.

NPPES Registry Identity

NPI1053615260
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameSTATE OF IDAHO
Location Address700 E ALICE STBlackfoot, ID 83221-4925
Mailing Address700 E Alice St, Po Box 400Blackfoot, ID 83221-4925 · (208) 785-8506 · Fax (208) 785-8518
Fax(208) 785-8518
Organization SubpartYesParent: State Hospital South
Authorized OfficialLorna B ColvinPatient Account Specialist · (208) 785-8506
Enumeration DateJanuary 3, 2011
NPI 1053615260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in ID · 17
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
700 E ALICE ST, Blackfoot, ID 83221

Other Names 1

Doing Business AsState Hospital South Group

Other Identifiers 4

Medicaid1992789101ID
Medicare OSCAR/certification134010ID
Other00844ID · Blue Cross
Other20315ID · Regence Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
700 E ALICE ST
BLACKFOOT, ID 83221
Physician Assistant
700 E ALICE ST
BLACKFOOT, ID 83221
Internal Medicine
700 E ALICE ST
BLACKFOOT, ID 83221
Psychiatry & Neurology (Psychiatry)
700 E ALICE ST
BLACKFOOT, ID 83221
Pharmacist
700 E ALICE ST
BLACKFOOT, ID 83221
Skilled Nursing Facility
700 E ALICE ST, BOX 400
BLACKFOOT, ID 83221
Nurse Practitioner (Psychiatric/Mental Health)
700 E ALICE ST
BLACKFOOT, ID 83221
Psychiatry & Neurology (Psychiatry)
700 E ALICE ST, STATE HOSPITAL SOUTH
BLACKFOOT, ID 83221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is State Of Idaho's NPI number?

The NPI number for State Of Idaho is 1053615260. It was assigned to this organization in the NPPES registry on January 3, 2011. The provider is doing business as State Hospital South Group.

Where is State Of Idaho located?

State Of Idaho is located at 700 E Alice St, Blackfoot, ID 83221. The listed phone number is (208) 785-8506.

What is State Of Idaho's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for State Of Idaho was last updated on January 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.