Life Counseling Center Inc. | |
112 12th Ave Rd Nampa ID 83686-5051 | |
(208) 465-5433 | |
Not Available |
Full Name | Life Counseling Center Inc. |
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Speciality | Counselor |
Location | 112 12th Ave Rd, Nampa, Idaho |
Authorized Official Name and Position | Emily A Allen (OWNER, SECRETARY) |
Authorized Official Contact | 2084655433 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Life Counseling Center Inc. 112 12th Ave Rd Nampa ID 83686-5011 Ph: (208) 465-5433 | Life Counseling Center Inc. 112 12th Ave Rd Nampa ID 83686-5051 Ph: (208) 465-5433 |
NPI Number | 1841206604 |
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Provider Enumeration Date | 08/01/2006 |
Last Update Date | 06/27/2011 |
Medicare PECOS PAC ID | 4385822493 |
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Medicare Enrollment ID | O20110620000425 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841206604 | NPI | - | NPPES |
8J745 | Other | ID | BLUE CROSS OF IDAHO |
000010153409 | Other | ID | BLUE CROSS OF IDAHO |
806994000 | Medicaid | ID | |
807395800 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Robin D Fox |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447220801 PECOS PAC ID: 0547434128 Enrollment ID: I20111116000458 |
Provider Name | Alicia May |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1588949069 PECOS PAC ID: 3072873397 Enrollment ID: I20180207000401 |
Provider Name | Amy M Byron-sadiki |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1326466871 PECOS PAC ID: 2668714221 Enrollment ID: I20190430002912 |
Provider Name | Jeffrey D Wright |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1043370141 PECOS PAC ID: 3476731159 Enrollment ID: I20240213004318 |
Provider Name | Alicia Simpson |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1790163855 PECOS PAC ID: 6800230178 Enrollment ID: I20240215001005 |
Provider Name | Stephanie Nicole Helton |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1568912723 PECOS PAC ID: 5597101592 Enrollment ID: I20240313001097 |
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