Whitetail Treatment and Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WHITETAIL TREATMENT AND COUNSELING LLC

Practice address

925 N Main St Ste D
Meridian, ID 83642-2301

Phone

(208) 907-5322

NPI assigned

May 5, 2022

Last updated

May 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wendy Perez, LCSW, ACADCNPI 1750638730

Title

Owner

Phone

(208) 859-9110

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wendy Perez, LCSW, ACADC

  • Clinical Social Worker
  • Meridian, ID
  • NPI 1750638730
  NPD Authorized official

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1528704350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N MAIN ST STE D",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422301",
            "telephone_number": "208-907-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N MAIN ST STE D",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422301",
            "telephone_number": "208-907-5322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 S 16th St",
            "address_purpose": "LOCATION",
            "city": "Payette",
            "state": "ID",
            "postal_code": "836613513",
            "country_code": "US",
            "telephone_number": "208-907-5322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITETAIL TREATMENT AND COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-859-9110",
        "authorized_official_credential": "LCSW, ACADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly R Whitehead-Price, NP-C
• Kaela Grace Whitehead, LCSW
• Leslee Lynn Whiteman, LCPC
• Robert Theodore Whiteman III, PHARM.D.
• Whitestone Dental, LLC
• Hope Elizabeth Whitman, PT, DPT
• Tyler T Whitney, PSYD
• Joel E Whitt, D.M.D.
• Wholesome Chiropractic, PLLC
• Cathie Darlene Wick, LCSW

• Clinical Social Worker in Meridian, ID
• Providers in Meridian, 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 May 5, 2022; 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.