Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Portneuf Valley Family Center

Organization Counselor · NPI 1174629976

Portneuf Valley Family Center is a Counselor in Pocatello, Idaho. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
7

Practice location Address checks out

444 Hospital Way Ste 477
Pocatello, ID 83201-2744
Phone: (208) 233-7832
Fax: (208) 233-7835
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X
Counselor Taxonomy 101Y00000X
Mental Health Counselor Taxonomy 101YM0800X
Social Worker Taxonomy 104100000X
Psychiatry Physician Taxonomy 2084P0800X
Physician Assistant Taxonomy 363A00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1174629976
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert De Wall — Owner/Administrator · (208) 233-7832
NPI enumeratedSeptember 16, 2006
Last updated in NPPESJune 27, 2025
Certification dateJune 27, 2025
Mailing address444 Hospital Way Ste 477, Pocatello, ID 83201-2744

Other providers in Pocatello