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

14 Emerson LN
Kellogg, ID 83837-2454

Phone

(208) 783-0660

Fax

(208) 783-7542

NPI assigned

Jan 23, 2014

Last updated

Jan 23, 2014By the provider in NPPES

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 Caudle

Title

Cbo

Phone

(256) 880-3339

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1689097834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 EAGLETREE LN SW",
            "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": "14 EMERSON LN",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "838372454",
            "telephone_number": "208-783-0660",
            "fax_number": "208-783-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL ALLIANCE FAMILY SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUEL TSI HOLDING, LLC",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "CAUDLE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CBO",
        "authorized_official_telephone_number": "256-880-3339",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "W132383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Kellogg, ID
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.