| Mountain Pine Therapy Pllc | |
|
555 Burnside Ave Middleton ID 83644-1141 | |
| (208) 695-3231 | |
| Not Available |
| Full Name | Mountain Pine Therapy Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 555 Burnside Ave, Middleton, Idaho |
| Authorized Official Name and Position | Timothy L Streight (COUNSELOR) |
| Authorized Official Contact | 2086953231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Pine Therapy Pllc 555 Burnside Ave Middleton ID 83644-1141 Ph: (208) 695-3231 | Mountain Pine Therapy Pllc 555 Burnside Ave Middleton ID 83644-1141 Ph: (208) 695-3231 |
| NPI Number | 1366389603 |
|---|---|
| Provider Enumeration Date | 05/04/2026 |
| Last Update Date | 05/04/2026 |
| Certification Date | 05/04/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366389603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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