| Cornerstone Psychological Associates, Pllc | |
|
1755 Westgate Dr Suite 260 Boise ID 83704-7174 | |
| (208) 373-0790 | |
| (208) 373-0816 |
| Full Name | Cornerstone Psychological Associates, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1755 Westgate Dr, Boise, Idaho |
| Authorized Official Name and Position | Joseph Al Lipetzky (MANAGER) |
| Authorized Official Contact | 2083730790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Psychological Associates, Pllc 1755 N Westgate Dr Suite 260 Boise ID 83704-7174 Ph: (208) 373-0790 | Cornerstone Psychological Associates, Pllc 1755 Westgate Dr Suite 260 Boise ID 83704-7174 Ph: (208) 373-0790 |
| NPI Number | 1184766396 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 12/12/2018 |
| Medicare PECOS PAC ID | 6103801683 |
|---|---|
| Medicare Enrollment ID | O20040619000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184766396 | NPI | - | NPPES |
| 342018 | Other | ID | MANAGED HEALTH NETWORK |
| 8G759 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Becky Huskinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972645711 PECOS PAC ID: 5395831317 Enrollment ID: I20081028000353 |
| Provider Name | Joseph A Lipetzky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467440065 PECOS PAC ID: 0840276309 Enrollment ID: I20110517000589 |
| Provider Name | Robert T Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962490474 PECOS PAC ID: 1658558598 Enrollment ID: I20110602000204 |
| Provider Name | Heidi Rachelle Tennyson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043404064 PECOS PAC ID: 2163698143 Enrollment ID: I20170828004796 |
| Provider Name | Michael Dennis Harmon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417181108 PECOS PAC ID: 8527110063 Enrollment ID: I20190705000255 |
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