| Luke & Spencer Behavioral Health Pllc | |
|
1904 Jennie Lee Dr Idaho Falls ID 83404-6159 | |
| (208) 406-4822 | |
| Not Available |
| Full Name | Luke & Spencer Behavioral Health Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1904 Jennie Lee Dr, Idaho Falls, Idaho |
| Authorized Official Name and Position | David Spencer (OWNER) |
| Authorized Official Contact | 2089745200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luke & Spencer Behavioral Health Pllc 1904 Jennie Lee Dr Idaho Falls ID 83404-6159 Ph: () - | Luke & Spencer Behavioral Health Pllc 1904 Jennie Lee Dr Idaho Falls ID 83404-6159 Ph: (208) 406-4822 |
| NPI Number | 1427834571 |
|---|---|
| Provider Enumeration Date | 09/05/2023 |
| Last Update Date | 01/04/2024 |
| Certification Date | 01/04/2024 |
| Medicare PECOS PAC ID | 5092167940 |
|---|---|
| Medicare Enrollment ID | O20240117000890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427834571 | NPI | - | NPPES |
| Provider Name | David E Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669705414 PECOS PAC ID: 8022321918 Enrollment ID: I20150721002570 |
| Provider Name | Kristy Ann Pendleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659797090 PECOS PAC ID: 6709184518 Enrollment ID: I20160816000424 |
| Provider Name | Lloyd Cody Luke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710291117 PECOS PAC ID: 1355793209 Enrollment ID: I20240205001695 |
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