Lost River Counseling Pllc | |
1070 Riverwalk Dr Ste 264 Idaho Falls ID 83402-3343 | |
(208) 219-7655 | |
Not Available |
Full Name | Lost River Counseling Pllc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 1070 Riverwalk Dr Ste 264, Idaho Falls, Idaho |
Authorized Official Name and Position | Daniel James Griffin (OWNER/THERAPIST) |
Authorized Official Contact | 2082196304 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lost River Counseling Pllc 113 E 14th St Idaho Falls ID 83404-5909 Ph: (208) 219-6304 | Lost River Counseling Pllc 1070 Riverwalk Dr Ste 264 Idaho Falls ID 83402-3343 Ph: (208) 219-7655 |
NPI Number | 1750157400 |
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Provider Enumeration Date | 12/04/2023 |
Last Update Date | 06/07/2024 |
Certification Date | 06/07/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750157400 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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