| Evergreen Counseling Llc | |
|
1920 E 17th St Ste 240 Idaho Falls ID 83404-8036 | |
| (208) 589-8690 | |
| (208) 523-8978 |
| Full Name | Evergreen Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1920 E 17th St Ste 240, Idaho Falls, Idaho |
| Authorized Official Name and Position | Connie Croft (BILLING MANAGER) |
| Authorized Official Contact | 2085252090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Counseling Llc 1601 E 17th St Idaho Falls ID 83404-6313 Ph: (208) 525-2090 | Evergreen Counseling Llc 1920 E 17th St Ste 240 Idaho Falls ID 83404-8036 Ph: (208) 589-8690 |
| NPI Number | 1285154054 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 06/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285154054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LCPC-2674 (Idaho) | Primary |
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