Rathdrum Counseling Center, LLC

Organization Active NPI Clinical Social Worker · Rathdrum, ID

NPI 1083152144 · NPPES record last updated Feb 8, 2017

Key facts

NPI
1083152144
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCSW 36280 (ID)
Legal business name
RATHDRUM COUNSELING CENTER, LLC
Practice address
14954 N Coeur Dalene St
Rathdrum, ID 83858-6484
Phone
(208) 687-0538
Fax
(208) 687-3185
NPI assigned
Feb 8, 2017
Organization subpart
No

Authorized official

Name
Lynn M Russell, LCSW
Title
Owner/Director
Phone
(208) 687-0538

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

14954 N Coeur Dalene St
Rathdrum, ID 83858
Phone (208) 687-0538

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X LCSW 36280 ID Yes

Addresses

Primary practice location

14954 N Coeur Dalene St
Rathdrum, ID 83858-6484

Mailing address

14954 N Coeur Dalene St
Rathdrum, ID 83858-6484
Phone (208) 687-0538

Other identifiers

IdentifierTypeStateIssuer
1437270097MedicaidID

Other providers in Rathdrum, ID

All providers in Rathdrum, ID · Clinical Social Worker in Idaho

Sources for this page

Verify at the official NPI Registry.