| Spirit Counseling Services Pllc | |
|
9494 N Government Way Ste 103 Hayden ID 83835-9848 | |
| (208) 967-6895 | |
| (208) 277-0766 |
| Full Name | Spirit Counseling Services Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 9494 N Government Way Ste 103, Hayden, Idaho |
| Authorized Official Name and Position | Shannon Denisce Andrews (OWNER/PROVIDER) |
| Authorized Official Contact | 2089676895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spirit Counseling Services Pllc Po Box 1575 Post Falls ID 83877-1575 Ph: (208) 967-6895 | Spirit Counseling Services Pllc 9494 N Government Way Ste 103 Hayden ID 83835-9848 Ph: (208) 967-6895 |
| NPI Number | 1982235982 |
|---|---|
| Provider Enumeration Date | 01/28/2020 |
| Last Update Date | 10/21/2023 |
| Certification Date | 10/21/2023 |
| Medicare PECOS PAC ID | 6507296019 |
|---|---|
| Medicare Enrollment ID | O20200424000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982235982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shannon Denisce Andrews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477009041 PECOS PAC ID: 7911295175 Enrollment ID: I20161004002253 |
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