| Caldwell Psychological Services P.a. | |
|
815 Fillmore Caldwell ID 83605-4173 | |
| (208) 459-6962 | |
| (208) 459-4476 |
| Full Name | Caldwell Psychological Services P.a. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 815 Fillmore, Caldwell, Idaho |
| Authorized Official Name and Position | Phares Lindeman Book (PSYCHOLOGIST) |
| Authorized Official Contact | 2084596962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Psychological Services P.a. 815 Fillmore Caldwell ID 83605-4173 Ph: (208) 459-6962 | Caldwell Psychological Services P.a. 815 Fillmore Caldwell ID 83605-4173 Ph: (208) 459-6962 |
| NPI Number | 1104083724 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 01/24/2012 |
| Medicare PECOS PAC ID | 8426225533 |
|---|---|
| Medicare Enrollment ID | O20120112000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104083724 | NPI | - | NPPES |
| 16848280 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 202193 (Idaho) | Primary |
| Provider Name | Phares L Book |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386660678 PECOS PAC ID: 4486685690 Enrollment ID: I20050827000144 |
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