Robert Casey Price Jr., M.COUN
Individual provider Active NPI Professional Counselor · Pocatello, DC
NPI 1770910903 · NPPES record last updated Oct 2, 2013
Key facts
- NPI
- 1770910903
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 5359 (ID)
- Practice address
- 110 S 19TH Ave
Pocatello, DC 83201 - Phone
- (208) 234-4722
- NPI assigned
- Oct 2, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 5359 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bannock Youth Foundation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5359 | ID | Yes |
Addresses
Primary practice location
110 S 19TH Ave
Pocatello, DC 83201
Mailing address
110 S 19TH Ave
Pocatello, DC 83201
Phone (208) 234-4722
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2013. 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.