| Priestley Mental Health Inc | |
|
75 S 1st W Preston ID 83263-1259 | |
| (208) 852-2370 | |
| (208) 852-5570 |
| Full Name | Priestley Mental Health Inc |
|---|---|
| Speciality | Social Worker |
| Location | 75 S 1st W, Preston, Idaho |
| Authorized Official Name and Position | David Priestley (OWNER DIRECTOR) |
| Authorized Official Contact | 2083390227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Priestley Mental Health Inc Po Box 54 Franklin ID 83237-0054 Ph: () - | Priestley Mental Health Inc 75 S 1st W Preston ID 83263-1259 Ph: (208) 852-2370 |
| NPI Number | 1073660320 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/07/2013 |
| Medicare PECOS PAC ID | 5092025726 |
|---|---|
| Medicare Enrollment ID | O20151110001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073660320 | NPI | - | NPPES |
| 806081800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 26656 (Idaho) | Primary |
| Provider Name | Karen H Hull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720411002 PECOS PAC ID: 9133439284 Enrollment ID: I20151102002652 |
| Provider Name | David R Priestley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265865554 PECOS PAC ID: 8426368051 Enrollment ID: I20151113000770 |
| Provider Name | Dallas R Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083913164 PECOS PAC ID: 9133476344 Enrollment ID: I20180719000823 |
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Pres Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 223 N State St, Preston, ID 83263 Phone: 208-852-0634 Fax: 208-852-2136 | |
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