| West Wind Mental Health | |
|
820 S Latah St Ste 106 Boise ID 83705-2255 | |
| (208) 572-2883 | |
| Not Available |
| Full Name | West Wind Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 820 S Latah St Ste 106, Boise, Idaho |
| Authorized Official Name and Position | Brenda Tennant (OWNER) |
| Authorized Official Contact | 2085722883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Wind Mental Health 820 S Latah St Ste 106 Boise ID 83705-2255 Ph: (208) 572-2883 | West Wind Mental Health 820 S Latah St Ste 106 Boise ID 83705-2255 Ph: (208) 572-2883 |
| NPI Number | 1982366670 |
|---|---|
| Provider Enumeration Date | 10/10/2021 |
| Last Update Date | 10/10/2021 |
| Certification Date | 09/29/2021 |
| Medicare PECOS PAC ID | 4981096997 |
|---|---|
| Medicare Enrollment ID | O20220125002983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982366670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brenda Nadine Tennant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194044149 PECOS PAC ID: 6507010543 Enrollment ID: I20130129000327 |
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