Broadtree Integrative Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BROADTREE INTEGRATIVE COUNSELING

Practice address

409 N Main St
Hailey, ID 83333-8416

Phone

(208) 922-7064

Fax

(208) 928-7647

NPI assigned

Sep 11, 2018

Organization subpart

No

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

Authorized official

Name

Stephanie Hatzenbuehler, LCSW

Title

LCSW/Owner

Phone

(208) 922-7064

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1467935841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N MAIN ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338416",
            "telephone_number": "208-922-7064",
            "fax_number": "208-928-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N MAIN ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338416",
            "telephone_number": "208-922-7064",
            "fax_number": "208-928-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADTREE INTEGRATIVE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "HATZENBUEHLER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "LCSW/OWNER",
        "authorized_official_telephone_number": "208-922-7064",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1831362821",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hailey, ID
• Providers in Hailey, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.