| Indigo Waters Counseling Services | |
|
13406 Donner Pass Rd Truckee CA 96161-3822 | |
| (530) 448-0203 | |
| Not Available |
| Full Name | Indigo Waters Counseling Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 13406 Donner Pass Rd, Truckee, California |
| Authorized Official Name and Position | Kirsten Brutzman-livak (OWNER) |
| Authorized Official Contact | 5304480203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Waters Counseling Services Po Box 2874 Olympic Valley CA 96146-2874 Ph: (530) 448-0203 | Indigo Waters Counseling Services 13406 Donner Pass Rd Truckee CA 96161-3822 Ph: (530) 448-0203 |
| NPI Number | 1013388966 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 10/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013388966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 29893 (California) | Primary |
| 305R00000X | Preferred Provider Organization | 29893 (California) | Secondary |
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