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PRO ACTIVE BEHAVIORAL HEALTH
NPI 1073634713
Counselor - Mental Health in Burley, ID

Active since April 02, 2007CLIA Certified · 2 labs
1369 E 16TH ST STE 2, BURLEY, ID 83318(208) 878-3423(208) 878-3424 Get Directions Write a Review

NPPES record last updated: September 15, 2021. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Pro Active Behavioral Health NPPES

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

PRO ACTIVE BEHAVIORAL HEALTH (NPI 1073634713) is a healthcare organization registered as a mental health in Burley, Idaho and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Frank J. Knight, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073634713
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NamePRO ACTIVE ADVANTAGE, LLC
Location Address1369 E 16TH ST STE 2Burley, ID 83318-2008
Mailing Address215 University DrGooding, ID 83330-6155 · (208) 934-5880 · Fax (208) 934-5876
Phone(208) 878-3423
Fax(208) 878-3424
Organization SubpartNo
Authorized OfficialFrank J. KnightCeo · (208) 934-5880
Enumeration DateApril 2, 2007
Last NPPES UpdateSeptember 15, 2021
NPPES CertifiedSeptember 15, 2021
✔ NPI 1073634713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1369 E 16TH ST STE 2, Burley, ID 83318
Open in Google Maps ↗

Other Names 1

Doing Business AsPro Active Behavioral Health

Other Identifiers 1

Medicaid8073811ID

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2345760

Proactive Behavioral Health · Burley, ID
Active · expires Jun 16, 2028
CLIA Number13D2345760
Laboratory TypeSud Outpatient Treatment
Certificate Effective DateJune 17, 2026
Certificate Expiration DateJune 16, 2028
Laboratory DirectorErin M. Goodfellow
Laboratory Phone(208) 878-3423
Laboratory LocationProactive Behavioral Health1369 E 16th #2, Burley, ID 83318
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2345768

Proactive Behavioral Health · Gooding, ID
Active · expires Jun 16, 2028
CLIA Number13D2345768
Laboratory TypeSud Outpatient Treatment
Certificate Effective DateJune 17, 2026
Certificate Expiration DateJune 16, 2028
Laboratory DirectorErin M. Goodfellow
Laboratory Phone(208) 934-5880
Laboratory LocationProactive Behavioral Health215 University Ave, Gooding, ID 83330
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

PRO ACTIVE ADVANTAGE, LLC
Psychologist (Rehabilitation)
1369 E 16TH ST STE 2
BURLEY, ID 83318
Cassia County (208) 878-3423

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 Pro Active Advantage, LLC's NPI number?

The NPI number for Pro Active Advantage, LLC is 1073634713. It was assigned to this organization in the NPPES registry on April 2, 2007. The provider is doing business as Pro Active Behavioral Health.

Where is Pro Active Advantage, LLC located?

Pro Active Advantage, LLC is located at 1369 E 16th St Ste 2, Burley, ID 83318. The listed phone number is (208) 878-3423.

What is Pro Active Advantage, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Does Pro Active Advantage, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pro Active Advantage, LLC was last updated on September 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.