| Nicolette Phillips, LCSW | |
|
304 N State St, Grangeville, ID 83530-1769 | |
| (208) 983-0235 | |
| Not Available |
| Full Name | Nicolette Phillips |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 304 N State St, Grangeville, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215672290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-41516 (Idaho) | Primary |
| Entity Name | Camas Professional Counseling |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033326301 PECOS PAC ID: 3476579160 Enrollment ID: O20071204000702 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicolette Phillips, LCSW Po Box 627, Grangeville, ID 83530-0627 Ph: (208) 983-0235 | Nicolette Phillips, LCSW 304 N State St, Grangeville, ID 83530-1769 Ph: (208) 983-0235 |
Mr. Mark A Hand, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 113 W North St, Grangeville, ID 83530 Phone: 208-827-6714 | |
Morris Michel Bentley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 365 Center Road, Grangeville, ID 83530 Phone: 208-983-5535 Fax: 208-983-5575 | |
Jessica Melvin, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 207 Ne 7th St, Grangeville, ID 83530 Phone: 253-709-3647 |