Healthcare Provider Details

I. General information

NPI: 1598012700
Provider Name (Legal Business Name): TUELLER COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 W BROADWAY ST
IDAHO FALLS ID
83402-2996
US

IV. Provider business mailing address

2265 W BROADWAY ST
IDAHO FALLS ID
83402-2996
US

V. Phone/Fax

Practice location:
  • Phone: 208-524-7400
  • Fax: 208-524-8004
Mailing address:
  • Phone: 208-524-7400
  • Fax: 208-524-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY STEPHEN HADDON-DENNIS
Title or Position: BILLING MANAGER
Credential:
Phone: 208-524-7400