Gateway Counseling, Inc | |
427 N Main St Suite 101 Pocatello ID 83204-3016 | |
(208) 242-3771 | |
(208) 242-3772 |
Full Name | Gateway Counseling, Inc |
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Speciality | Social Worker |
Location | 427 N Main St, Pocatello, Idaho |
Authorized Official Name and Position | Corey Lynn Richardson (OPERATIONS DIRECTOR) |
Authorized Official Contact | 2082423771 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Gateway Counseling, Inc 427 N Main St Suite 101 Pocatello ID 83204-3016 Ph: (208) 242-3771 | Gateway Counseling, Inc 427 N Main St Suite 101 Pocatello ID 83204-3016 Ph: (208) 242-3771 |
NPI Number | 1922392869 |
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Provider Enumeration Date | 06/08/2011 |
Last Update Date | 08/24/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922392869 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | LCSW-28906 (Idaho) | Secondary |
104100000X | Social Worker | LCSW-28906 (Idaho) | Primary |
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