James Franklin Gump, BS, CADC

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

NPI 1205699709 · NPPES record last updated Feb 6, 2024

Key facts

NPI
1205699709
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CADC-5039 (ID)
Practice address
1720 18TH Ave
Lewiston, ID 83501-4047
Phone
(208) 746-4097
NPI assigned
Feb 6, 2024
Sex
Male
Sole proprietor
No

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
CADC-5039IDMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CADC-5039 ID Yes

Addresses

Primary practice location

1720 18TH Ave
Lewiston, ID 83501-4047

Mailing address

1720 18TH Ave
Lewiston, ID 83501-4047
Phone (208) 746-4097

Other providers in Lewiston, ID

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

Sources for this page

Verify at the official NPI Registry.