Lew House, LCPC

Individual provider Active NPI Professional Counselor · Middleton, ID

NPI 1558497487 · NPPES record last updated Oct 4, 2008

Key facts

NPI
1558497487
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LCPC 3822 (ID)
Practice address
511 W Main St
Middleton, ID 83644-5545
Phone
(208) 697-1915
NPI assigned
Feb 26, 2007
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

State licenses

LicenseStateTypeSpecialty
LCPC 3822IDMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LCPC 3822 ID Yes

Addresses

Primary practice location

511 W Main St
Middleton, ID 83644-5545

Mailing address

2678 S Stonehedge Dr
Nampa, ID 83686-1215
Phone (208) 697-1915

Other providers in Middleton, ID

All providers in Middleton, ID · Professional Counselor in Idaho

Sources for this page

Verify at the official NPI Registry.