| Cress Creek Counseling Pllc | |
|
33 Madison Professional Park Rexburg ID 83440-2057 | |
| (208) 243-9304 | |
| (208) 656-5668 |
| Full Name | Cress Creek Counseling Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 33 Madison Professional Park, Rexburg, Idaho |
| Authorized Official Name and Position | Lisa K Nelson (OFFICE MANAGER/BILLER) |
| Authorized Official Contact | 2085145288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cress Creek Counseling Pllc 33 Madison Professional Park Rexburg ID 83440-2057 Ph: (208) 243-9304 | Cress Creek Counseling Pllc 33 Madison Professional Park Rexburg ID 83440-2057 Ph: (208) 243-9304 |
| NPI Number | 1376251835 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 8224476585 |
|---|---|
| Medicare Enrollment ID | O20240404003823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376251835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Trevor James Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174971014 PECOS PAC ID: 1951749217 Enrollment ID: I20240405001431 |
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