Susan Beckstead
Individual provider Active NPI Mental Health Counselor · Pocatello, ID
NPI 1740469121 · NPPES record last updated Nov 1, 2007
Key facts
- NPI
- 1740469121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LSW28318 (ID)
- Practice address
- 2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100 - Phone
- (208) 236-1600
- Fax
- (208) 236-6695
- NPI assigned
- Nov 1, 2007
- Sex
- Female
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LSW28318 | ID | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LSW28318 | ID | Yes |
Addresses
Primary practice location
2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100
Mailing address
2055 Garrett Way
Ste 1
Pocatello, ID 83201-5100
Phone (208) 236-1600
Other providers in Pocatello, ID
- Christian Beauregard
- Angela M. Beck
- Tracy Becker
- Jennifer Beckstead
- Robert Mitchell Beckstead
- Samantha J. Bedolla
- Brittany Morgan Beers
- Behavioral Enhancement Services & Treatment LLC
- Behavioral Enhancement Services & Treatment LLC
- Behavioral Enhancement Services & Treatment LLC
All providers in Pocatello, ID · Mental Health Counselor in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2007. 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.