Provider Demographics
| NPI: | 1912112277 |
|---|---|
| Name: | CRITCHFIELD, LORILEE (PHD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | LORILEE |
| Middle Name: | |
| Last Name: | CRITCHFIELD |
| Suffix: | |
| Gender: | F |
| Credentials: | PHD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 675 N CENTER ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | OAKLEY |
| Mailing Address - State: | ID |
| Mailing Address - Zip Code: | 83346-9723 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 208-862-9220 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 488 BLUE LAKES BLVD N STE 106 |
| Practice Address - Street 2: | |
| Practice Address - City: | TWIN FALLS |
| Practice Address - State: | ID |
| Practice Address - Zip Code: | 83301-4882 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 208-736-7178 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2007-05-11 |
| Last Update Date: | 2025-09-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| ID | 202157 | 103G00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TF0200X, 103TM1800X, 103TP0814X, 103TP2701X, 103TR0400X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 103G00000X | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | |
| No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
| No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |
| No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
| No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
| No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
| No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family |
| No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic |
| No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities |
| No | 103TP0814X | Behavioral Health & Social Service Providers | Psychologist | Psychoanalysis |
| No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
| No | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| ID | 000010017764 | Other | REGENCE BLUE SHIELD |
| ID | N5798 | Other | BLUE CROSS |