Brian Chambers, B.S.., CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Boise, ID

NPI 1104257070 · NPPES record last updated Dec 4, 2013

Key facts

NPI
1104257070
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
101YA0400X (ID)
Practice address
400 N Benjamin LN
Suite 201
Boise, ID 83704-5094
Phone
(208) 287-5630
Fax
(208) 287-5609
NPI assigned
Dec 3, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
101YA0400XIDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ada County Juvenile Court Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 101YA0400X ID Yes

Addresses

Primary practice location

400 N Benjamin LN
Suite 201
Boise, ID 83704-5094

Mailing address

400 N Benjamin LN
Suite 201
Boise, ID 83704-5094
Phone (208) 287-5630

Other providers in Boise, ID

All providers in Boise, ID · Addiction (Substance Use Disorder) Counselor in Idaho

Sources for this page

Verify at the official NPI Registry.