| Lost River Counseling Pllc | |
|
1070 Riverwalk Dr Ste 264 Idaho Falls ID 83402-3343 | |
| (208) 219-7655 | |
| Not Available |
| Full Name | Lost River Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1070 Riverwalk Dr Ste 264, Idaho Falls, Idaho |
| Authorized Official Name and Position | Daniel James Griffin (OWNER/THERAPIST) |
| Authorized Official Contact | 2082196304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lost River Counseling Pllc 113 E 14th St Idaho Falls ID 83404-5909 Ph: (208) 219-6304 | Lost River Counseling Pllc 1070 Riverwalk Dr Ste 264 Idaho Falls ID 83402-3343 Ph: (208) 219-7655 |
| NPI Number | 1750157400 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 06/07/2024 |
| Certification Date | 06/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750157400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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