| Inner Light Counseling, Llc | |
|
61 E 1st S Soda Springs ID 83276 | |
| (208) 425-6932 | |
| (435) 417-3113 |
| Full Name | Inner Light Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 61 E 1st S, Soda Springs, Idaho |
| Authorized Official Name and Position | Sherie Ann Flagg (OWNER/DIRECTOR) |
| Authorized Official Contact | 2084256932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Light Counseling, Llc 61 E 1st S Soda Springs ID 83276-1437 Ph: (208) 425-6932 | Inner Light Counseling, Llc 61 E 1st S Soda Springs ID 83276 Ph: (208) 425-6932 |
| NPI Number | 1184022105 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 05/16/2018 |
| Medicare PECOS PAC ID | 2466715594 |
|---|---|
| Medicare Enrollment ID | O20180614001300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184022105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 80117423501 (Utah) | Primary |
| Provider Name | Sherie Ann Flagg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194085423 PECOS PAC ID: 5890040851 Enrollment ID: I20180614001379 |
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Caribou Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S 3rd W, Soda Springs, ID 83276 Phone: 208-547-3341 Fax: 208-547-2790 |