Kim Alexander Nelson, MS, LPC | |
22480 Duff Ln, Middleton, ID 83644-6041 | |
(208) 800-2758 | |
Not Available |
Full Name | Kim Alexander Nelson |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 22480 Duff Ln, Middleton, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275085433 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC-6027 (Idaho) | Secondary |
101YP2500X | Counselor - Professional | LCPC-6361 (Idaho) | Primary |
Entity Name | Stillwater Connection |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457867962 PECOS PAC ID: 0941640668 Enrollment ID: O20240429002295 |
Mailing Address | Practice Location Address |
---|---|
Kim Alexander Nelson, MS, LPC 22480 Duff Ln, Middleton, ID 83644-6041 Ph: (208) 800-2758 | Kim Alexander Nelson, MS, LPC 22480 Duff Ln, Middleton, ID 83644-6041 Ph: (208) 800-2758 |
Stephanie Lee Lefavour, COUI Counselor Medicare: Not Enrolled in Medicare Practice Location: 22480 Duff Ln, Middleton, ID 83644 Phone: 208-965-4502 | |
Renee Johanson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 22480 Duff Ln, Middleton, ID 83644 Phone: 986-200-7921 | |
Angela Sillito, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 672 Fairhaven, Middleton, ID 83644 Phone: 509-449-1555 | |
Angela Baird Hepworth, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 25612 Kingsbury Rd, Middleton, ID 83644 Phone: 208-870-2069 | |
Brandi Bechtel, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 509 S Middleton Rd, Middleton, ID 83644 Phone: 208-683-8320 | |
Mr. Lew House, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 511 W Main St, Middleton, ID 83644 Phone: 208-697-1915 |