Summit Counseling Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SUMMIT COUNSELING SERVICES LLC

Practice address

655 S 4TH E Ste 104
Preston, ID 83263-1616

Phone

(435) 994-0508

NPI assigned

Aug 25, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Blau

Title

Owner

Phone

(435) 994-0508

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1902206287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S 4TH E STE 104",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631616",
            "telephone_number": "435-994-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S 4TH E STE 104",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631616",
            "telephone_number": "435-994-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "BLAU",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-994-0508"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.