Pettingill Counseling Services, Pc

LBN: Pettingill Counseling Services, Pc
Pettingill Counseling Services, Pc is an health care organization with primary practice located at 2267 Teton Plz , Idaho Falls ID 83404-6486. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as the primary health care specialty. Pettingill Counseling Services, Pc can be contacted via phone (208) 542-9919, or through Pettingill, Tamara K. via phone (208) 542-9919.

Contact Information

Primary practice address
2267 Teton Plz Idaho Falls ID 83404-6486
Fax: (208) 542-6272
Website:
Authorized official contact:
Name: Pettingill, Tamara K. Licensed Clinical Social Worker (LCSW)

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X LCSW-24477 Idaho

Profile Details

NPI number 1811019904
LBN Legal business name Pettingill Counseling Services, Pc
DBA Doing business as
Authorized official Pettingill, Tamara K. Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811019904 NPPES
Idaho MEDICAID 807357200

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