| Flow State Psychotherapy, Llc | |
|
613 N River St Ste 1a Hailey ID 83333-8438 | |
| (406) 546-2025 | |
| Not Available |
| Full Name | Flow State Psychotherapy, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 613 N River St Ste 1a, Hailey, Idaho |
| Authorized Official Name and Position | Lydia Missal (OWNER/PROVIDER) |
| Authorized Official Contact | 4065462025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Flow State Psychotherapy, Llc Po Box 5895 Hailey ID 83333-5895 Ph: (406) 546-2025 | Flow State Psychotherapy, Llc 613 N River St Ste 1a Hailey ID 83333-8438 Ph: (406) 546-2025 |
| NPI Number | 1891370284 |
|---|---|
| Provider Enumeration Date | 03/17/2021 |
| Last Update Date | 03/17/2021 |
| Certification Date | 03/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891370284 | NPI | - | NPPES |
| 1083959332 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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