| Labyrinth Assessment & Behavioral Services Pllc | |
|
20 N Main St Ste 6 Malad City ID 83252-1281 | |
| (208) 233-9136 | |
| (208) 233-9136 |
| Full Name | Labyrinth Assessment & Behavioral Services Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 20 N Main St Ste 6, Malad City, Idaho |
| Authorized Official Name and Position | Donna Call (CREDENTIALING) |
| Authorized Official Contact | 2083170268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Labyrinth Assessment & Behavioral Services Pllc 20 N Main St Ste 6 Malad City ID 83252-1281 Ph: (208) 766-7623 | Labyrinth Assessment & Behavioral Services Pllc 20 N Main St Ste 6 Malad City ID 83252-1281 Ph: (208) 233-9136 |
| NPI Number | 1013494301 |
|---|---|
| Provider Enumeration Date | 07/19/2018 |
| Last Update Date | 08/19/2022 |
| Certification Date | 08/19/2022 |
| Medicare PECOS PAC ID | 4880060714 |
|---|---|
| Medicare Enrollment ID | O20221018002946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013494301 | NPI | - | NPPES |
| LCPC-3275 | Other | ID | MENTAL HEALTH |
| Provider Name | Dallas R Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083913164 PECOS PAC ID: 9133476344 Enrollment ID: I20180719000823 |
| Provider Name | Jody Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285850867 PECOS PAC ID: 9234505165 Enrollment ID: I20240606003970 |
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