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IDAHO DEPT OF HEALTH & WELFARE REGION 7 CMH CLINIC IF
NPI 1629104047
Clinic/Center - Adolescent and Children Mental Health in Idaho Falls, ID

Active since February 27, 2007
150 SHOUP AVE, SUITE 17, IDAHO FALLS, ID 83402(208) 528-5700(208) 528-5747 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If NPPES

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

IDAHO DEPT OF HEALTH & WELFARE REGION 7 CMH CLINIC IF (NPI 1629104047) is a healthcare organization registered as an adolescent and children mental health in Idaho Falls, Idaho and active in the NPI registry since February 2007. The organization lists Melissa M Bean, Program Manager, as its authorized official.

NPPES Registry Identity

NPI1629104047
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameIDAHO DEPT OF HEALTH & WELFARE REGION 7 CMH CLINIC IF
Location Address150 SHOUP AVE, SUITE 17Idaho Falls, ID 83402-3657
Mailing Address150 Shoup Ave, Suite 17Idaho Falls, ID 83402-3657 · (208) 528-5700 · Fax (208) 528-5747
Phone(208) 528-5700
Fax(208) 528-5747
Organization SubpartNo
Authorized OfficialMelissa M BeanProgram Manager · (208) 528-5706
Enumeration DateFebruary 27, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1629104047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
150 SHOUP AVE, Idaho Falls, ID 83402
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Other Identifiers 3

Medicaid8073848ID
Other000010019677Blue Shield
OtherHW157Blue Cross Of Idaho

Other Providers at the Same Location NPPES 20

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

MELISSA GALLANT RN
Registered Nurse
150 SHOUP AVE, SUITE 17
IDAHO FALLS, ID 83402
Bonneville County (208) 528-5700
MARIA RODRIGUEZ-MONCADA
Developmental Therapist
150 SHOUP AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-4061
ZACHARY WIXOM LMSW
Counselor (Mental Health)
150 SHOUP AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-5712
TODD JENSEN
Registered Nurse
150 SHOUP AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-5700
KATHLEEN KUNKEL
Developmental Therapist
150 SHOUP AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 528-4062
MS. KRISTA MARIE GRIFFIN LCSW
Social Worker (Clinical)
150 SHOUP AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 716-4372
SANDRA CUMMINGS
Developmental Therapist
150 SHOUP AVE, SUITE 19
IDAHO FALLS, ID 83402
Bonneville County (208) 528-4070
TIMOTHY MCHUGH
Physician Assistant
150 SHOUP AVE, SUITE 17
IDAHO FALLS, ID 83402
Bonneville County (208) 528-5755

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 Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If's NPI number?

The NPI number for Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If is 1629104047. It was assigned to this organization in the NPPES registry on February 27, 2007.

Where is Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If located?

Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If is located at 150 Shoup Ave Suite 17, Idaho Falls, ID 83402. The listed phone number is (208) 528-5700.

What is Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Idaho Dept Of Health & Welfare Region 7 Cmh Clinic If was last updated on August 22, 2020. 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.