| Mindhaven Mental Health | |
|
407 N Sherwood Dr Nampa ID 83651-1865 | |
| (208) 249-6464 | |
| Not Available |
| Full Name | Mindhaven Mental Health |
|---|---|
| Speciality | Counselor |
| Location | 407 N Sherwood Dr, Nampa, Idaho |
| Authorized Official Name and Position | Lisa Harrison (OWNER) |
| Authorized Official Contact | 2082496464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindhaven Mental Health 407 N Sherwood Dr Nampa ID 83651-1865 Ph: (208) 249-6464 | Mindhaven Mental Health 407 N Sherwood Dr Nampa ID 83651-1865 Ph: (208) 249-6464 |
| NPI Number | 1447959275 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 01/20/2024 |
| Certification Date | 01/20/2024 |
| Medicare PECOS PAC ID | 3274970462 |
|---|---|
| Medicare Enrollment ID | O20240323000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447959275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lisa Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346600723 PECOS PAC ID: 7618369380 Enrollment ID: I20220110002538 |
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