| Unbound Counseling Services, Inc. | |
|
2140 Diane Ln Pocatello ID 83201-1910 | |
| (208) 339-2024 | |
| Not Available |
| Full Name | Unbound Counseling Services, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 2140 Diane Ln, Pocatello, Idaho |
| Authorized Official Name and Position | Julianne Maria Andrysiak (PRESIDENT) |
| Authorized Official Contact | 2083392024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Unbound Counseling Services, Inc. 2140 Diane Ln Pocatello ID 83201-1910 Ph: (208) 339-2024 | Unbound Counseling Services, Inc. 2140 Diane Ln Pocatello ID 83201-1910 Ph: (208) 339-2024 |
| NPI Number | 1528717022 |
|---|---|
| Provider Enumeration Date | 03/22/2022 |
| Last Update Date | 03/22/2022 |
| Certification Date | 03/19/2022 |
| Medicare PECOS PAC ID | 3274920830 |
|---|---|
| Medicare Enrollment ID | O20220428002020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528717022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Julianne M Andrysiak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841720224 PECOS PAC ID: 1658701321 Enrollment ID: I20200904000877 |
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