| Jesse Tangen Lcsw Counseling Pllc | |
|
410 S Orchard St Ste 124 Boise ID 83705-1210 | |
| (701) 893-8828 | |
| Not Available |
| Full Name | Jesse Tangen Lcsw Counseling Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 410 S Orchard St Ste 124, Boise, Idaho |
| Authorized Official Name and Position | Jesse Tangen (OWNER) |
| Authorized Official Contact | 7018938828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse Tangen Lcsw Counseling Pllc 410 S Orchard St Ste 124 Boise ID 83705-1210 Ph: (701) 893-8828 | Jesse Tangen Lcsw Counseling Pllc 410 S Orchard St Ste 124 Boise ID 83705-1210 Ph: (701) 893-8828 |
| NPI Number | 1932829819 |
|---|---|
| Provider Enumeration Date | 08/31/2022 |
| Last Update Date | 08/31/2022 |
| Certification Date | 08/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932829819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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