State of Idaho Department of Health and Welfare
NPI 1609267715ActiveOrganization· Psychologist· Blackfoot, ID
Psychologist in Blackfoot, Idaho, registered in NPPES in February 2015, part of State of Idaho Department of Health and Wel. The authorized official on file is Lynn D. Shields, Patient Account Spec.
Overview
| NPI | 1609267715 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | State of Idaho Department of Health and Wel |
| NPI issued | Feb 11, 2015 |
| Last updated in NPPES | Mar 25, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Psychologist, Clinical | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other psychologists in Blackfoot
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