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PRO ACTIVE BEHAVIORAL HEALTH
NPI 1407253669
Community/Behavioral Health in Gooding, ID

Active since December 03, 2014
215 UNIVERSITY DR, GOODING, ID 83330(208) 934-5880(208) 934-5876 Get Directions Write a Review

NPPES record last updated: September 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 15, 2021, Dec 19, 2019 (2 updates tracked since 2019).

About Pro Active Behavioral Health NPPES

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

PRO ACTIVE BEHAVIORAL HEALTH (NPI 1407253669) is a healthcare organization registered as a community/behavioral health in Gooding, Idaho and active in the NPI registry since December 2014. The organization lists Pat Marecki, Human Resources, as its authorized official.

NPPES Registry Identity

NPI1407253669
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NamePRO ACTIVE ADVANTAGE, LLC
Location Address215 UNIVERSITY DRGooding, ID 83330-6155
Mailing Address562 Shoup Ave WTwin Falls, ID 83301-5029 · (208) 734-0407 · Fax (208) 734-3534
Phone(208) 934-5880
Fax(208) 934-5876
Organization SubpartNo
Authorized OfficialPat MareckiHuman Resources · (208) 772-4935
Enumeration DateDecember 3, 2014
Last NPPES UpdateSeptember 15, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2021
✔ NPI 1407253669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in ID · LPC-5654
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
215 UNIVERSITY DR, Gooding, ID 83330
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Other Names 1

Doing Business AsPro Active Behavioral Health

Other Providers at the Same Location NPPES 6

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

STEPHANIE JAN BOWLES M.ED,CRC,LPC,NCC
Counselor
215 UNIVERSITY DR
GOODING, ID 83330
Gooding County (208) 595-4946
JOSHUA D COOKE M.S. LPC NCC QSUDP
Counselor (Mental Health)
215 UNIVERSITY DR
GOODING, ID 83330
Gooding County (801) 934-5880
DENISE MARIE JENSEN LPC
Counselor (Professional)
215 UNIVERSITY DR
GOODING, ID 83330
Gooding County (208) 934-5880
PRO ACTIVE ADVANTAGE, LLC
Counselor
215 UNIVERSITY DR
GOODING, ID 83330
Gooding County (208) 934-5880
BRANDON DOUGLAS KNIGHT LMSW
Social Worker
215 UNIVERSITY DR
GOODING, ID 83330
Gooding County (208) 934-5880
PRO ACTIVE ADVANTAGE, LLC
Psychologist (Cognitive & Behavioral)
215 UNIVERSITY DR
GOODING, ID 83330
Gooding County (208) 934-5880

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 1407253669. It was assigned to this organization in the NPPES registry on December 3, 2014. The provider is doing business as Pro Active Behavioral Health.

Where is Pro Active Advantage, LLC located?

Pro Active Advantage, LLC is located at 215 University Dr, Gooding, ID 83330. The listed phone number is (208) 934-5880.

What is Pro Active Advantage, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

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 4 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.