| Lakehaven Counseling Pllc | |
|
21 W Commerce Dr Ste F Hayden ID 83835-9289 | |
| (208) 704-0046 | |
| Not Available |
| Full Name | Lakehaven Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 21 W Commerce Dr Ste F, Hayden, Idaho |
| Authorized Official Name and Position | Sarah Hlebichuk (OWNER) |
| Authorized Official Contact | 2087040046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakehaven Counseling Pllc Po Box 895 Hayden ID 83835-0895 Ph: (208) 704-0046 | Lakehaven Counseling Pllc 21 W Commerce Dr Ste F Hayden ID 83835-9289 Ph: (208) 704-0046 |
| NPI Number | 1831806124 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 11/04/2022 |
| Certification Date | 11/04/2022 |
| Medicare PECOS PAC ID | 4587038435 |
|---|---|
| Medicare Enrollment ID | O20230316001641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831806124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sarah E Hlebichuk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285985101 PECOS PAC ID: 5496129348 Enrollment ID: I20230316001725 |
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