| Gateway Counseling Incorporated | |
|
151 N 3rd Ave Ste 330 Pocatello ID 83201-6331 | |
| (208) 242-3771 | |
| (208) 242-3772 |
| Full Name | Gateway Counseling Incorporated |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 151 N 3rd Ave Ste 330, Pocatello, Idaho |
| Authorized Official Name and Position | Corey Lynn Richardson (OWNER) |
| Authorized Official Contact | 2082423771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Counseling Incorporated 151 N 3rd Ave Ste 330 Pocatello ID 83201-6331 Ph: (208) 242-3771 | Gateway Counseling Incorporated 151 N 3rd Ave Ste 330 Pocatello ID 83201-6331 Ph: (208) 242-3771 |
| NPI Number | 1528366424 |
|---|---|
| Provider Enumeration Date | 03/02/2011 |
| Last Update Date | 02/25/2020 |
| Certification Date | 02/25/2020 |
| Medicare PECOS PAC ID | 3870776610 |
|---|---|
| Medicare Enrollment ID | O20110331000651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528366424 | NPI | - | NPPES |
| Provider Name | Corey L Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285962779 PECOS PAC ID: 4789867524 Enrollment ID: I20110331000665 |
| Provider Name | Lacy D Lehman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710002100 PECOS PAC ID: 9335388776 Enrollment ID: I20130617000134 |
| Provider Name | Joann S Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841565199 PECOS PAC ID: 2769834712 Enrollment ID: I20240116001844 |
| Provider Name | Shelley Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548602998 PECOS PAC ID: 5698217313 Enrollment ID: I20240610003408 |
| Provider Name | Ontaya Acedo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104436062 PECOS PAC ID: 3870022411 Enrollment ID: I20250127000526 |
| Provider Name | Alison Nicole Rider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053989947 PECOS PAC ID: 3870023757 Enrollment ID: I20250206003015 |
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