| Healing Springs Counseling Llc | |
|
534 Trejo St Ste 200h Rexburg ID 83440-5408 | |
| (208) 541-9075 | |
| Not Available |
| Full Name | Healing Springs Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 534 Trejo St Ste 200h, Rexburg, Idaho |
| Authorized Official Name and Position | Brian Mendoza (ADMINISTRATOR) |
| Authorized Official Contact | 6306325822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Springs Counseling Llc 534 Trejo St Ste 200h Rexburg ID 83440-5408 Ph: (208) 541-9075 | Healing Springs Counseling Llc 534 Trejo St Ste 200h Rexburg ID 83440-5408 Ph: (208) 541-9075 |
| NPI Number | 1801669817 |
|---|---|
| Provider Enumeration Date | 11/01/2023 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 8325490923 |
|---|---|
| Medicare Enrollment ID | O20240119000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801669817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jonathan M Moses |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891353199 PECOS PAC ID: 6800274838 Enrollment ID: I20220603001654 |
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