| Linking Resources | |
|
5272 Canterbury St St P3 Chubbuck ID 83202-4954 | |
| (208) 406-9107 | |
| Not Available |
| Full Name | Linking Resources |
|---|---|
| Speciality | Social Worker |
| Location | 5272 Canterbury St, Chubbuck, Idaho |
| Authorized Official Name and Position | Brandi M Merrill (OWNER) |
| Authorized Official Contact | 2084069107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Linking Resources 5272 Canterbury St Chubbuck ID 83202-4954 Ph: (208) 406-9107 | Linking Resources 5272 Canterbury St St P3 Chubbuck ID 83202-4954 Ph: (208) 406-9107 |
| NPI Number | 1205500832 |
|---|---|
| Provider Enumeration Date | 08/06/2021 |
| Last Update Date | 05/20/2024 |
| Certification Date | 03/10/2022 |
| Medicare PECOS PAC ID | 1557758398 |
|---|---|
| Medicare Enrollment ID | O20220427000134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205500832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brandi M Merrill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407053812 PECOS PAC ID: 7810384658 Enrollment ID: I20220427003116 |
| Provider Name | Misty D Olsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740880053 PECOS PAC ID: 2466897228 Enrollment ID: I20240301003856 |
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