The Undiscovered Self, PC
NPI 1487514212ActiveOrganization· Psychologist· Boise, ID
Psychologist in Boise, Idaho, registered in NPPES in November 2025. The authorized official on file is John Anthony Beradino, PHD, Psychologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1487514212 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 14, 2025 |
| Last updated in NPPES | Nov 14, 2025 |
| Certified by provider | Nov 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
Other Psychologist providers in Boise
- 1861063745
- 1447495114
- 1366466021
- 1598959322
- 1306230958
- 1891890703
- 1912332446
- 1225521164
- 1649357716
- 1457813719
- 1295881480
- 1871868463