Labyrinth Assessment & Behavioral Services PLLC
Organization Active NPI Community/Behavioral Health Agency · Malad City, ID
NPI 1013494301 · NPPES record last updated Aug 19, 2022
Key facts
- NPI
- 1013494301
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- LCPC3275 (ID)
- Legal business name
- LABYRINTH ASSESSMENT & BEHAVIORAL SERVICES PLLC
- Practice address
- 20 N Main St Ste 6
Malad City, ID 83252-1281 - Phone
- (208) 233-9136
- Fax
- (208) 233-9136
- NPI assigned
- Jul 19, 2018
- Organization subpart
- No
Authorized official
- Name
- Donna Call
- Title
- Credentialing
- Phone
- (208) 317-0268
Practitioners 3
-
Jody Owens, MS, LCPC
-
Ronda Sue Schaeffer, MS LPC
-
Kenneth James Taylor, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221018002946 | ID | Part B Supplier - Clinic/Group Practice | 4880060714 |
Receives reassigned benefits from 1 practitioner Practice locations: Malad City, ID |
National Provider Directory
Locations
20 N Main St
Ste 6
Malad City, ID 83252
Phone (208) 766-7623
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Community/Behavioral Health Agency | 251S00000X | LCPC3275 | ID | Yes |
Addresses
Primary practice location
20 N Main St Ste 6
Malad City, ID 83252-1281
Mailing address
20 N Main St Ste 6
Malad City, ID 83252-1281
Phone (208) 766-7623
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCPC-3275 | Other | ID | MENTAL HEALTH |
Other names
- Labyrinth
Other providers in Malad City, ID
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- Misty M Martinsen
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All providers in Malad City, ID · Community/Behavioral Health Agency in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.