| Central Idaho Counseling | |
|
125 Commerce St. Suite B Mccall ID 83638 | |
| (208) 634-2962 | |
| (208) 634-5064 |
| Full Name | Central Idaho Counseling |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 125 Commerce St., Mccall, Idaho |
| Authorized Official Name and Position | Eric A Mikkelson (OWNER/CLINICIAN) |
| Authorized Official Contact | 2086342962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Idaho Counseling 125 Commerce St. Suite B Mccall ID 83638 Ph: (208) 634-2962 | Central Idaho Counseling 125 Commerce St. Suite B Mccall ID 83638 Ph: (208) 634-2962 |
| NPI Number | 1275944498 |
|---|---|
| Provider Enumeration Date | 05/09/2014 |
| Last Update Date | 12/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275944498 | NPI | - | NPPES |
| 20002621 | Other | ID | PROVIDER TRANSACTION ACCESS NUMBER |
| 488228600C1 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Idaho) | Secondary |
| 106H00000X | Marriage & Family Therapist | LMFT-6050 (Idaho) | Primary |
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