| Centerpoint Counseling Services, Llc | |
|
393 E 2nd N Rexburg ID 83440-1605 | |
| (208) 359-4840 | |
| (208) 359-9010 |
| Full Name | Centerpoint Counseling Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 393 E 2nd N, Rexburg, Idaho |
| Authorized Official Name and Position | Vonda Winfree (CO-OWNER) |
| Authorized Official Contact | 2082013606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerpoint Counseling Services, Llc 393 E 2nd N Rexburg ID 83440-1605 Ph: (208) 359-4840 | Centerpoint Counseling Services, Llc 393 E 2nd N Rexburg ID 83440-1605 Ph: (208) 359-4840 |
| NPI Number | 1134458102 |
|---|---|
| Provider Enumeration Date | 12/21/2009 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Medicare PECOS PAC ID | 1456754373 |
|---|---|
| Medicare Enrollment ID | O20210729000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134458102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | D117890 (Idaho) | Primary |
| Provider Name | Jessica Tanner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548509920 PECOS PAC ID: 1951548767 Enrollment ID: I20130515000661 |
| Provider Name | Julie Raye Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508530676 PECOS PAC ID: 1355748716 Enrollment ID: I20210928000760 |
| Provider Name | James P Morris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427584762 PECOS PAC ID: 8921351362 Enrollment ID: I20220815003382 |
| Provider Name | James N Mccoy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790211092 PECOS PAC ID: 4284988460 Enrollment ID: I20220816002627 |
| Provider Name | Geoffrey R Winfree |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205042843 PECOS PAC ID: 3274936190 Enrollment ID: I20240103004628 |
| Provider Name | Isaac Jacob Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306497227 PECOS PAC ID: 7113379207 Enrollment ID: I20240112004114 |
| Provider Name | Gary Cole Ratcliffe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851738173 PECOS PAC ID: 2163874272 Enrollment ID: I20240113000369 |
| Provider Name | Brandon M Buhler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881823979 PECOS PAC ID: 4082066527 Enrollment ID: I20240119001890 |
| Provider Name | Richard Harold Degraw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275014045 PECOS PAC ID: 7214370147 Enrollment ID: I20240208000319 |
| Provider Name | Matthew Aaron Douglass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396509311 PECOS PAC ID: 1254771744 Enrollment ID: I20240501001604 |
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