| Keaton Jake Suitter, LPC | |
|
502 S Woodruff Ave, Idaho Falls, ID 83401-5298 | |
| (208) 346-7500 | |
| Not Available |
| Full Name | Keaton Jake Suitter |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 3 Years |
| Location | 502 S Woodruff Ave, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639852668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC-9695 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| 4 Pillars Of Success Llc | 4688027188 | 19 |
| Pearl Health Clinic | 0840356077 | 38 |
| Entity Name | Pearl Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447426465 PECOS PAC ID: 0840356077 Enrollment ID: O20090312000617 |
| Entity Name | 4 Pillars of Success LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619134277 PECOS PAC ID: 4688027188 Enrollment ID: O20240131004474 |
| Mailing Address | Practice Location Address |
|---|---|
| Keaton Jake Suitter, LPC 502 S Woodruff Ave, Idaho Falls, ID 83401-5298 Ph: (208) 346-7500 | Keaton Jake Suitter, LPC 502 S Woodruff Ave, Idaho Falls, ID 83401-5298 Ph: (208) 346-7500 |
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 |