Pettingill Counseling Services, Professional Corporation

LBN: Pettingill Counseling Services, Professional Corporation
Pettingill Counseling Services, Professional Corporation is an health care organization with primary practice located at 1302 E 17Th St , Idaho Falls ID 83404-6270. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Pettingill Counseling Services, Professional Corporation can be contacted via phone (208) 542-9919, or through Pettingill, Tamara K. via phone (208) 542-9919.

Contact Information

Primary practice address
1302 E 17Th St Idaho Falls ID 83404-6270
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 / Mental Health 101YM0800X

Profile Details

NPI number 1891919890
LBN Legal business name Pettingill Counseling Services, Professional Corporation
DBA Doing business as
Authorized official Pettingill, Tamara K. Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2007
Last updated Jan 4th, 2023 - about last year

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 1891919890 NPPES
Idaho MEDICAID 806803500

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