| Stages Mental Health, Pllc | |
|
804 14th Ave S Nampa ID 83651-4630 | |
| (208) 409-8710 | |
| Not Available |
| Full Name | Stages Mental Health, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 804 14th Ave S, Nampa, Idaho |
| Authorized Official Name and Position | Dawn R Juker (CEO) |
| Authorized Official Contact | 2084098710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stages Mental Health, Pllc 804 14th Ave S Nampa ID 83651-4630 Ph: (208) 409-8710 | Stages Mental Health, Pllc 804 14th Ave S Nampa ID 83651-4630 Ph: (208) 409-8710 |
| NPI Number | 1245952019 |
|---|---|
| Provider Enumeration Date | 09/16/2022 |
| Last Update Date | 09/16/2022 |
| Certification Date | 09/16/2022 |
| Medicare PECOS PAC ID | 1052789864 |
|---|---|
| Medicare Enrollment ID | O20221129002804 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245952019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dawn Ranae Juker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972958643 PECOS PAC ID: 4789052598 Enrollment ID: I20221129002836 |
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