Sequel Alliance Family Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

W132383 Issued in ID

Legal business name

SEQUEL ALLIANCE FAMILY SERVICES, LLC

Practice address

212 Rodeo Dr
Moscow, ID 83843-9798

Phone

(208) 882-5960

Fax

(208) 882-0857

NPI assigned

Jan 24, 2014

Organization subpart

Yes

Parent organization

SEQUEL TSI HOLDING, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary Caudle

Title

Cbo Director of Patient Accounts

Phone

(256) 880-3339

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1154744357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 EAGLETREE LN SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016478",
            "telephone_number": "256-880-3339",
            "fax_number": "256-880-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 RODEO DR",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838439798",
            "telephone_number": "208-882-5960",
            "fax_number": "208-882-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL ALLIANCE FAMILY SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUEL TSI HOLDING, LLC",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "CAUDLE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CBO DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "256-880-3339",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "W132383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Moscow, ID
• Providers in Moscow, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.