Organization
IDAHO NEUROPSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S BLACK PHD, ABN (OWNER/CEO)
(208) 207-8331
Entity
Organization
Contact information
Practice address
1305 S FIVE MILE RD, BOISE, ID 83709-1306
(208) 789-0910
(208) 789-0916
Mailing address
10400 W OVERLAND RD # 357, BOISE, ID 83709-1433
(208) 789-0910
(208) 789-0916
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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