| Kevin Colin Soran Henson, | |
|
314 Badiola St, Caldwell, ID 83605-4389 | |
| (208) 454-8389 | |
| Not Available |
| Full Name | Kevin Colin Soran Henson |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 314 Badiola St, Caldwell, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194552240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Idaho) | Primary |
| Entity Name | Human Supports Of Idaho |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922340124 PECOS PAC ID: 0244485894 Enrollment ID: O20130305000118 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Colin Soran Henson, 314 Badiola St, Caldwell, ID 83605-4389 Ph: (208) 454-8389 | Kevin Colin Soran Henson, 314 Badiola St, Caldwell, ID 83605-4389 Ph: (208) 454-8389 |
Dia Michelle Rivers, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 15134 Greenwing St, Caldwell, ID 83607 Phone: 208-740-3372 | |
Blanca America Valadez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 923 Grant St, Caldwell, ID 83605 Phone: 208-585-3375 Fax: 208-585-6152 | |
Mr. John K Bishop, LPC LICENSED PROFESS Counselor Medicare: Not Enrolled in Medicare Practice Location: 16226 Horizon Dr, Caldwell, ID 83607 Phone: 208-602-4680 Fax: 208-454-9770 | |
Ms. Lyndell Jackson, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2020 Blaine St, Caldwell, ID 83605 Phone: 208-880-6127 Fax: 208-455-6244 | |
Mrs. Wanda Lee Newton, MED Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 Main Street, Suite B, Caldwell, ID 83605 Phone: 208-454-2471 | |
Michelle Lynn Drinkwine, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 718 S 7th Ave, Caldwell, ID 83605 Phone: 208-454-1576 Fax: 208-454-9863 | |
Jennifer Padilla, LPC Counselor Medicare: Medicare Enrolled Practice Location: 2005 Arlington Ave, Caldwell, ID 83605 Phone: 208-318-1362 Fax: 208-345-3502 |