| Mountain Laurel Therapy Llc | |
|
133 Main Ave W Suite 300 Twin Falls ID 83301 | |
| (910) 308-6764 | |
| Not Available |
| Full Name | Mountain Laurel Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 133 Main Ave W, Twin Falls, Idaho |
| Authorized Official Name and Position | Amanda Lynn Overacre (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 9103086764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Laurel Therapy Llc 1011 Bell Ln Kimberly ID 83341-5182 Ph: (910) 308-6764 | Mountain Laurel Therapy Llc 133 Main Ave W Suite 300 Twin Falls ID 83301 Ph: (910) 308-6764 |
| NPI Number | 1548001522 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 06/04/2024 |
| Certification Date | 05/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548001522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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