Bernadette Jamie Rundhaug, MED
Individual provider Active NPI Professional Counselor · Cottonwood, ID
NPI 1003948845 · NPPES record last updated Oct 17, 2019
Key facts
- NPI
- 1003948845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LCPC-7085 (ID)
- Practice address
- 701 Lewiston St
Cottonwood, ID 83522 - Phone
- (208) 962-3251
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC-7085 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary'S Hospital Inc | Current |
Accepting new patients |
Locations
2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085
701 Lewiston St
Cottonwood, ID 83522
Phone (208) 962-3251
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LCPC-7085 | ID | Yes |
Addresses
Primary practice location
701 Lewiston St
Cottonwood, ID 83522
Mailing address
PO Box 137
Cottonwood, ID 83522-0137
Phone (208) 962-3251
Other practice location 1
518 Oak
Kamiah, ID 83536
Phone (208) 935-2585
Other practice location 2
1055 Riverside Ave
Orofino, ID 83544
Phone (208) 476-5777
Other providers in Cottonwood, ID
- Haley J Minnehan
- Denise Marie Nuxoll
- Jeremy D Ostrander
- April Lynn Parsells
- Christopher P Roach
- Jamie Scheffler
- Alvin Jackson Secrest III
- Ronald L Sigler
- Joseph Smith
- St. Mary'S Hospital Inc
All providers in Cottonwood, ID · Professional Counselor in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.