Spirit In Light Healing Center | |
1426 Addison Ave E Twin Falls ID 83301-5202 | |
(208) 280-0365 | |
(208) 549-7253 |
Full Name | Spirit In Light Healing Center |
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Speciality | Counselor |
Location | 1426 Addison Ave E, Twin Falls, Idaho |
Authorized Official Name and Position | Kathy Couch (OWNER) |
Authorized Official Contact | 2082800365 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Spirit In Light Healing Center 1426 Addison Ave E Twin Falls ID 83301-5202 Ph: (208) 280-0365 | Spirit In Light Healing Center 1426 Addison Ave E Twin Falls ID 83301-5202 Ph: (208) 280-0365 |
NPI Number | 1952979338 |
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Provider Enumeration Date | 06/14/2021 |
Last Update Date | 07/01/2021 |
Certification Date | 07/01/2021 |
Medicare PECOS PAC ID | 8628471299 |
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Medicare Enrollment ID | O20210721000728 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952979338 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Kathleen M Couch |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1255687521 PECOS PAC ID: 6709030026 Enrollment ID: I20130213000386 |
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