Dean Counseling Inc | |
2635 Channing Way Suite B Idaho Falls ID 83404-7518 | |
(208) 680-6488 | |
(208) 523-8978 |
Full Name | Dean Counseling Inc |
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Speciality | Social Worker |
Location | 2635 Channing Way, Idaho Falls, Idaho |
Authorized Official Name and Position | Travis A Dean (OWNER) |
Authorized Official Contact | 2086806488 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dean Counseling Inc 3820 E 180 N Rigby ID 83442-5775 Ph: (208) 680-6488 | Dean Counseling Inc 2635 Channing Way Suite B Idaho Falls ID 83404-7518 Ph: (208) 680-6488 |
NPI Number | 1558763490 |
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Provider Enumeration Date | 09/23/2014 |
Last Update Date | 10/27/2014 |
Medicare PECOS PAC ID | 5496079972 |
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Medicare Enrollment ID | O20150112001580 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558763490 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-27235 (Idaho) | Primary |
Provider Name | Travis A Dean |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1033252622 PECOS PAC ID: 2163611336 Enrollment ID: I20110104001265 |
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