| Susan Keeley Counseling Services, Pc | |
|
1042 W Mill Ave Suite 205 Coeur D Alene ID 83814-2489 | |
| (208) 755-7370 | |
| (208) 292-4544 |
| Full Name | Susan Keeley Counseling Services, Pc |
|---|---|
| Speciality | Counselor |
| Location | 1042 W Mill Ave, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Susan Elizabeth Keeley (PRESIDENT/OWNER) |
| Authorized Official Contact | 2087557370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Keeley Counseling Services, Pc 1042 W Mill Ave Suite 205 Coeur D Alene ID 83814-2489 Ph: (208) 755-7370 | Susan Keeley Counseling Services, Pc 1042 W Mill Ave Suite 205 Coeur D Alene ID 83814-2489 Ph: (208) 755-7370 |
| NPI Number | 1568768315 |
|---|---|
| Provider Enumeration Date | 01/26/2011 |
| Last Update Date | 02/04/2011 |
| Medicare PECOS PAC ID | 2769665454 |
|---|---|
| Medicare Enrollment ID | O20110317000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568768315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCSW30184 (Idaho) | Primary |
| Provider Name | Susan E Keeley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902098643 PECOS PAC ID: 0042493629 Enrollment ID: I20110318000461 |
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