| Caldwell Counseling Associates, Pllc | |
|
2020 Blaine St Caldwell ID 83605-4343 | |
| (208) 880-6127 | |
| (208) 455-6244 |
| Full Name | Caldwell Counseling Associates, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2020 Blaine St, Caldwell, Idaho |
| Authorized Official Name and Position | Lyndell V. Jackson (OWNER COUNSELOR) |
| Authorized Official Contact | 2088806127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Counseling Associates, Pllc 2020 Blaine St Caldwell ID 83605-4343 Ph: (208) 880-6127 | Caldwell Counseling Associates, Pllc 2020 Blaine St Caldwell ID 83605-4343 Ph: (208) 880-6127 |
| NPI Number | 1417024209 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417024209 | NPI | - | NPPES |
| Q1109 | Other | ID | BLUE CROSS OF ID |
| 000010016363 | Other | ID | REGENCE BLUE SHIELD OF ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCPC234 (Idaho) | Primary |
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