LAKE CITY COUNSELING CENTER NPI 1356981419

NPI Information

NPI: 1356981419
Provider Name: LAKE CITY COUNSELING CENTER
Classification: Peer Specialist - 175T00000X
Entity Type: Organization
Address:
9705 N SHAW ST
HAYDEN, ID
ZIP 83835
Phone: (208) 625-9981
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LAKE CITY COUNSELING CENTER is a peer specialist in Hayden, ID. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. LAKE CITY COUNSELING CENTER NPI is 1356981419. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9705 N SHAW ST
HAYDEN, ID
ZIP 83835-716
Phone: (208) 625-9981

The provider's authorized official is Jennifer Rian Tuttle .
The authorized official title is Owner and has the following contact phone number (208) 819-2716.

The enumeration date for this NPI number is 1/7/2020 and was last updated on 1/7/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1720513963	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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