| Amanda Moore, LPC | |
|
855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 | |
| (208) 552-0855 | |
| Not Available |
| Full Name | Amanda Moore |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 855 N Capital Ave Ste 1, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750152203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 10116 (Idaho) | Primary |
| Entity Name | High Country Behavioral Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295379865 PECOS PAC ID: 0648454587 Enrollment ID: O20200228002021 |
| Entity Name | Mental Health Specialty Group PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240916003985 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Moore, LPC 2195 Logan Dr, Idaho Falls, ID 83401-4404 Ph: (208) 357-8909 | Amanda Moore, LPC 855 N Capital Ave Ste 1, Idaho Falls, ID 83402-3405 Ph: (208) 552-0855 |
Desiree Jenks-asay, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 615 Hoopes Ave, Idaho Falls, ID 83401 Phone: 208-542-0352 |
Kelsey Lynn Cole, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 211 S Woodruff Ave Ste A3, Idaho Falls, ID 83401 Phone: 208-524-4818 Fax: 208-522-6630 |
Jamille Baxter Rogers, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 129 Stillwater Dr, Idaho Falls, ID 83404 Phone: 208-313-3202 |
Steven Orme, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 545 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-351-1447 |
Mckenzie Leigh Duncan, LPC Counselor Medicare: May Accept Medicare Assignments Practice Location: 1262 E 17th St, Idaho Falls, ID 83404 Phone: 208-346-0688 Fax: 208-620-3027 |
Mr. Jorge Padron, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 543 3rd St, Idaho Falls, ID 83401 Phone: 208-522-6925 Fax: 208-522-6934 |
Zachary Wixom, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 150 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-528-5712 |