| Pinnacle Counseling Center Northwest, Llc | |
|
2101 N Lakewood Dr Ste 220 Coeur D Alene ID 83814-2473 | |
| (208) 699-9065 | |
| Not Available |
| Full Name | Pinnacle Counseling Center Northwest, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2101 N Lakewood Dr Ste 220, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Kimberly S Lee (OWNER) |
| Authorized Official Contact | 2086999065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinnacle Counseling Center Northwest, Llc Po Box 3415 Hayden ID 83835-3415 Ph: (208) 699-9065 | Pinnacle Counseling Center Northwest, Llc 2101 N Lakewood Dr Ste 220 Coeur D Alene ID 83814-2473 Ph: (208) 699-9065 |
| NPI Number | 1376089896 |
|---|---|
| Provider Enumeration Date | 01/07/2017 |
| Last Update Date | 11/30/2020 |
| Certification Date | 11/30/2020 |
| Medicare PECOS PAC ID | 6901178722 |
|---|---|
| Medicare Enrollment ID | O20170814002796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376089896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-36216 (Idaho) | Primary |
| 251S00000X | Community/behavioral Health | LCSW-36216 (Idaho) | Secondary |
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