Self, Lylena Marie
Self, Lylena Marie is an individual health care provider with primary practice located at 1720 N Westgate Dr Ste 1A , Boise ID 83704-7164. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Self, Lylena Marie can be contacted via phone (208) 334-6938.Contact Information
Primary practice address
1720 N Westgate Dr Ste 1A
Boise ID 83704-7164
Phone: (208) 334-6938
Fax: (208) 334-0812
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | LCSW30738 | Idaho |
Profile Details
| NPI number | 1295093789 |
|---|---|
| LBN Legal business name | Self, Lylena Marie |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2012 |
| Last updated | May 2nd, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295093789 | NPPES |
| Idaho | Other | LCSW-30738 | BUREAU OF OCCUPATIONAL LICENSES |
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