| Padron Counseling Services, Llc | |
|
543 3rd St Idaho Falls ID 83401-3909 | |
| (208) 522-6925 | |
| (208) 522-6934 |
| Full Name | Padron Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 543 3rd St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Jorge Padron (CEO) |
| Authorized Official Contact | 2085894139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Padron Counseling Services, Llc 543 3rd St Idaho Falls ID 83401-3909 Ph: (208) 522-6925 | Padron Counseling Services, Llc 543 3rd St Idaho Falls ID 83401-3909 Ph: (208) 522-6925 |
| NPI Number | 1649606575 |
|---|---|
| Provider Enumeration Date | 09/24/2013 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 1254674559 |
|---|---|
| Medicare Enrollment ID | O20190529001644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649606575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Idaho) | Primary |
| Provider Name | Kristi Lyn Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396171153 PECOS PAC ID: 4284959974 Enrollment ID: I20150223000861 |
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