| Willow Sage Services Llc | |
|
211 S Woodruff Ave Ste A3 Idaho Falls ID 83401-4865 | |
| (208) 524-4818 | |
| (208) 522-6630 |
| Full Name | Willow Sage Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 211 S Woodruff Ave Ste A3, Idaho Falls, Idaho |
| Authorized Official Name and Position | Tresia Jones (OWNER) |
| Authorized Official Contact | 2082331276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Sage Services Llc 211 S Woodruff Ave Ste A3 Idaho Falls ID 83401-4865 Ph: (208) 233-1276 | Willow Sage Services Llc 211 S Woodruff Ave Ste A3 Idaho Falls ID 83401-4865 Ph: (208) 524-4818 |
| NPI Number | 1538611652 |
|---|---|
| Provider Enumeration Date | 10/25/2016 |
| Last Update Date | 05/09/2022 |
| Certification Date | 05/09/2022 |
| Medicare PECOS PAC ID | 8527341007 |
|---|---|
| Medicare Enrollment ID | O20170207001660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538611652 | NPI | - | NPPES |
| Provider Name | Pamela Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245603901 PECOS PAC ID: 8325491830 Enrollment ID: I20240131004756 |
| Provider Name | John Patrick O'neal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710318480 PECOS PAC ID: 8628411998 Enrollment ID: I20240205000887 |
| Provider Name | John P Condron |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972710564 PECOS PAC ID: 4486098126 Enrollment ID: I20240221001149 |
| Provider Name | Traci Alene Kettle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679622971 PECOS PAC ID: 2062857378 Enrollment ID: I20240227000710 |
| Provider Name | Shasta Lee Hardee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194992545 PECOS PAC ID: 2769829431 Enrollment ID: I20240318003052 |
Sullivan Mental Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-523-1558 Fax: 208-529-4788 | |
Youth And Family Renewal Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2935 Rollandet St, Idaho Falls, ID 83402 Phone: 208-542-2905 Fax: 208-522-2427 | |
Independence, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1230 N Skyline Dr, Ste. A, Idaho Falls, ID 83402 Phone: 208-524-0881 Fax: 208-524-0886 | |
Life Quest Family Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 586 1st St, Idaho Falls, ID 83401 Phone: 208-529-2920 | |
Access Point Family Sevices Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2680 Channing Way, Idaho Falls, ID 83404 Phone: 208-522-4026 Fax: 208-522-4138 | |
Integrated Family & Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3355 S Holmes Ave, Idaho Falls, ID 83404 Phone: 208-523-2080 Fax: 208-523-2799 | |
Childrens Supportive Services Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1565 E Lincoln Rd, Idaho Falls, ID 83401 Phone: 208-524-8996 Fax: 208-524-1205 |