| Fortify Family Counseling, Llc | |
|
720 Washington St Montpelier ID 83254-1401 | |
| (208) 220-4197 | |
| Not Available |
| Full Name | Fortify Family Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 720 Washington St, Montpelier, Idaho |
| Authorized Official Name and Position | David W. Roberts (PRESIDENT) |
| Authorized Official Contact | 2082204197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortify Family Counseling, Llc 720 Washington St Montpelier ID 83254-1401 Ph: () - | Fortify Family Counseling, Llc 720 Washington St Montpelier ID 83254-1401 Ph: (208) 220-4197 |
| NPI Number | 1457031965 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 07/19/2023 |
| Certification Date | 07/19/2023 |
| Medicare PECOS PAC ID | 2769928399 |
|---|---|
| Medicare Enrollment ID | O20240719000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457031965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Nancy Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386787521 PECOS PAC ID: 6800023144 Enrollment ID: I20131212001462 |
| Provider Name | Victoria Bertler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710207238 PECOS PAC ID: 9133531049 Enrollment ID: I20201217002952 |