| Bella-nacole Mental Health Services Llc | |
|
808 N 8th Ave Pocatello ID 83201-5718 | |
| (208) 226-4943 | |
| (208) 242-3892 |
| Full Name | Bella-nacole Mental Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 808 N 8th Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Wendy Jo Webb (OWNER) |
| Authorized Official Contact | 2082264943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella-nacole Mental Health Services Llc 850 E Young St Pocatello ID 83201-5736 Ph: (208) 220-8606 | Bella-nacole Mental Health Services Llc 808 N 8th Ave Pocatello ID 83201-5718 Ph: (208) 226-4943 |
| NPI Number | 1215432539 |
|---|---|
| Provider Enumeration Date | 03/28/2018 |
| Last Update Date | 11/07/2022 |
| Certification Date | 11/07/2022 |
| Medicare PECOS PAC ID | 4183972094 |
|---|---|
| Medicare Enrollment ID | O20180809004360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215432539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Mary B Spraktes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922355049 PECOS PAC ID: 1759533029 Enrollment ID: I20121212000592 |
| Provider Name | Lacy D Lehman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710002100 PECOS PAC ID: 9335388776 Enrollment ID: I20130617000134 |
| Provider Name | Kilynn L Hainline |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073162491 PECOS PAC ID: 4789050113 Enrollment ID: I20221026001005 |
| Provider Name | Shawn K Akina |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134217771 PECOS PAC ID: 1355794744 Enrollment ID: I20240201002898 |
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