Summit Creek Counseling LLC
Organization Active NPI Counselor · Malad City, ID
NPI 1609415199 · NPPES record last updated Dec 31, 2019
Key facts
- NPI
- 1609415199
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- SUMMIT CREEK COUNSELING LLC
- Practice address
- 57 Bannock St
Malad City, ID 83252-1240 - Phone
- (208) 220-6534
- NPI assigned
- Dec 31, 2019
- Organization subpart
- No
Authorized official
- Name
- Jodie Barnes, LPC
- Title
- Manager/Member
- Phone
- (208) 220-6534
Practitioners 1
-
Jodie Lynn Barnes, LCPC
National Provider Directory
Locations
57 Bannock St
Malad City, ID 83252
Phone (208) 220-6534
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes |
Addresses
Primary practice location
57 Bannock St
Malad City, ID 83252-1240
Mailing address
PO Box 35
Downey, ID 83234-0035
Phone (208) 220-6534
Other providers in Malad City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.