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2270 Teton Plz Idaho Falls ID 83404-6485 | |
| (801) 655-5450 | |
| (385) 225-9327 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 2270 Teton Plz, Idaho Falls, Idaho |
| Authorized Official Name and Position | Whitney Hebbert (OWNER) |
| Authorized Official Contact | 8016555450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1469 N 1200 W Orem UT 84057-2449 Ph: () - | 2270 Teton Plz Idaho Falls ID 83404-6485 Ph: (801) 655-5450 |
| NPI Number | 1023889839 |
|---|---|
| Provider Enumeration Date | 01/10/2024 |
| Last Update Date | 02/06/2025 |
| Certification Date | 02/06/2025 |
| Medicare PECOS PAC ID | 4880134535 |
|---|---|
| Medicare Enrollment ID | O20240909001384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023889839 | NPI | - | NPPES |
| Provider Name | Sungah Mcgary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669939401 PECOS PAC ID: 8921484254 Enrollment ID: I20240911001153 |
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