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

Jared Thomas John, PSY

Individual provider School Psychologist · NPI 1164300778

Jared Thomas John, PSY is a Clinical Psychologist in Idaho Falls, Idaho. Qualified in 2024, 2 years ago. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2025
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Practice location Address checks out

2001 S Woodruff Ave Ste 9
Idaho Falls, ID 83404-6371
Phone: (208) 419-3002
Fax: (208) 656-5652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

School Psychologist (primary) Taxonomy 103TS0200X · Licence PSY-9671673 (ID)

Record details

NPI number1164300778
Entity typeIndividual (Type 1)
GenderMale
Credentials PSY
Sole proprietorNo
NPI enumeratedAugust 22, 2025
Last updated in NPPESSeptember 12, 2025
Certification dateSeptember 12, 2025
Mailing address2001 S Woodruff Ave Ste 9, Idaho Falls, ID 83404-6371

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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