Northam, Edward John
Northam, Edward John is an sole proprietor health care provider with primary practice located at 923 16Th Ave S , Nampa ID 83651-4731. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Northam, Edward John can be contacted via phone (208) 965-8788.Contact Information
Primary practice address
923 16Th Ave S
Nampa ID 83651-4731
Phone: (208) 965-8788
Fax: (208) 965-2789
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 406 | Nebraska |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 5698 | Idaho |
Profile Details
| NPI number | 1326059072 |
|---|---|
| LBN Legal business name | Northam, Edward John |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Nov 18th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326059072 | NPPES |
| Nebraska | MEDICAID | 91185390827 | |
| Nebraska | Other | 345988000 | |
| Nebraska | Other | 114961 | |
| Nebraska | Other | 84913 | |
| Nebraska | MEDICAID | 91185390826 |
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