Clearwater Counseling
Organization Active NPI Social Worker · Grangeville, ID
NPI 1164542403 · NPPES record last updated Apr 20, 2009
Key facts
- NPI
- 1164542403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Social Worker 104100000X
- Legal business name
- CLEARWATER COUNSELING
- Practice address
- 318 E Main St
Grangeville, ID 83530-2238 - Phone
- (208) 983-7717
- Fax
- (208) 983-7787
- NPI assigned
- Mar 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Mark R Jones, LCSW
- Title
- Owner
- Phone
- (208) 743-8101
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Mark R Jones Dba Clearwater Counseling
Locations
318 E Main St
Grangeville, ID 83530
Phone (208) 500-2066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | Yes |
Addresses
Primary practice location
318 E Main St
Grangeville, ID 83530-2238
Mailing address
PO Box 1123
Lewiston, ID 83501-1123
Phone (208) 743-8101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807373700 | Medicaid | ID |
Other providers in Grangeville, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.