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

6334 Main St
Bonners Ferry, ID 83805-8519

Phone

(208) 267-0780

Fax

(208) 267-7941

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 E 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": "1235552431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 EAGLETREE LN SW",
            "address_2": "HUNTSVILLE",
            "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": "6334 MAIN ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838058519",
            "telephone_number": "208-267-0780",
            "fax_number": "208-267-7941"
        }
    ],
    "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_middle_name": "E",
        "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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• 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.