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

141 9TH St Ste 1
Lewiston, ID 83501-2136

Phone

(208) 746-0669

Fax

(208) 746-0717

NPI assigned

Jan 17, 2014

Last updated

Jan 17, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

SEQUEL TSI HOLDINGAs 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 Director of Patient Accounts

Phone

(256) 880-3339

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389916800000",
    "number": "1720400294",
    "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": "141 9TH ST STE 1",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012136",
            "telephone_number": "208-746-0669",
            "fax_number": "208-746-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL ALLIANCE FAMILY SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUEL TSI HOLDING",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-01-17",
        "status": "A",
        "authorized_official_last_name": "CAUDLE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CBO DIRECTOR OF PATIENT ACCOUNTS",
        "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 Lewiston, ID
• Providers in Lewiston, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.