| Woodhouse Counseling Llc | |
|
1262 E 17th St Idaho Falls ID 83404-6147 | |
| (208) 346-0688 | |
| Not Available |
| Full Name | Woodhouse Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1262 E 17th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Alicia Woodhouse (OFFICE MANAGER) |
| Authorized Official Contact | 2083460688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodhouse Counseling Llc 1262 E 17th St Idaho Falls ID 83404-6147 Ph: (208) 346-0688 | Woodhouse Counseling Llc 1262 E 17th St Idaho Falls ID 83404-6147 Ph: (208) 346-0688 |
| NPI Number | 1811349293 |
|---|---|
| Provider Enumeration Date | 07/08/2016 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 9739477738 |
|---|---|
| Medicare Enrollment ID | O20161006001303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811349293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-30245 (Idaho) | Primary |
| Provider Name | Royce Woodhouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265638647 PECOS PAC ID: 6709186034 Enrollment ID: I20151118001618 |
| Provider Name | Mark Gunther Rodel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407450216 PECOS PAC ID: 6901258367 Enrollment ID: I20240122001788 |
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