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NPI Code Detail

MEDICARE: SCOTT STANTLIFF

MEDICARE: SCOTT STANTLIFF
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLCPC-10257ID
2101YM0800XMental Health Counselor8278ID

General Provider Information

NPI Number : 1467115428
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT STANTLIFF
Provider Business Mailing Address
First Line : 709 DEARBORN ST
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4116
Country : US
Telephone Number : 208-376-7083
Fax Number :
Provider Business Practice Location Address
First Line : 709 DEARBORN ST
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4116
Country : US
Telephone Number : 208-376-7083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2021
Last Update Date : 03/09/2026

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Directions to “ SCOTT STANTLIFF ” Practice Location

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