| A Journey To A New Beginning | |
|
214 E Center St Ste 40 Pocatello ID 83201-6372 | |
| (208) 545-7966 | |
| (208) 241-6215 |
| Full Name | A Journey To A New Beginning |
|---|---|
| Speciality | Social Worker |
| Location | 214 E Center St Ste 40, Pocatello, Idaho |
| Authorized Official Name and Position | Deanna S Smith (OWNER) |
| Authorized Official Contact | 2082417681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Journey To A New Beginning 214 E Center St Ste 40 Pocatello ID 83201-6372 Ph: (208) 545-7966 | A Journey To A New Beginning 214 E Center St Ste 40 Pocatello ID 83201-6372 Ph: (208) 545-7966 |
| NPI Number | 1598405797 |
|---|---|
| Provider Enumeration Date | 03/29/2022 |
| Last Update Date | 03/29/2022 |
| Certification Date | 03/29/2022 |
| Medicare PECOS PAC ID | 3476931270 |
|---|---|
| Medicare Enrollment ID | O20220607002783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598405797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Deanna S Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093177719 PECOS PAC ID: 1658709092 Enrollment ID: I20200317002074 |
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