| Wildflower Wellness, Llc | |
|
200 S Main St Ste P3 Pocatello ID 83204-3261 | |
| (208) 251-6789 | |
| Not Available |
| Full Name | Wildflower Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 200 S Main St Ste P3, Pocatello, Idaho |
| Authorized Official Name and Position | Misity D Olsen (OWNER) |
| Authorized Official Contact | 2082516789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildflower Wellness, Llc 200 S Main St Ste P3 Pocatello ID 83204-3261 Ph: (208) 251-6789 | Wildflower Wellness, Llc 200 S Main St Ste P3 Pocatello ID 83204-3261 Ph: (208) 251-6789 |
| NPI Number | 1700642840 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Medicare PECOS PAC ID | 3476992835 |
|---|---|
| Medicare Enrollment ID | O20240417003925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700642840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Misty D Olsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740880053 PECOS PAC ID: 2466897228 Enrollment ID: I20240301003856 |
Allies Family Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 E Lander St, Pocatello, ID 83201 Phone: 208-234-2094 Fax: 208-234-2637 | |
Lighthouse For Recovery, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Yellowstone Ave, Suite D, Pocatello, ID 83201 Phone: 208-232-2908 Fax: 208-232-5423 | |
Apex Professional Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Wilson Ave, Suite C-3, Pocatello, ID 83201 Phone: 208-904-0225 Fax: 866-704-4580 | |
Behavioral Reform Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Yellowstone Ave Ste D, Pocatello, ID 83201 Phone: 208-238-9400 Fax: 208-238-9401 | |
Psychological Assessment Specialists Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1246 Yellowstone Ave Ste C5, Pocatello, ID 83201 Phone: 208-233-0150 Fax: 208-233-0159 | |
Broncho Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 772 E Ross Fork Road #41, Pocatello, ID 83202 Phone: 208-220-7520 | |
A To Z Family Services Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 Washington Ave, Pocatello, ID 83201 Phone: 208-478-9822 Fax: 208-478-6790 |