Healthcare Provider Details

I. General information

NPI: 1780851881
Provider Name (Legal Business Name): JOHN BRIAN HUFFER LCPC, LMHC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 12/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 E POLSTON AVE STE A
POST FALLS ID
83854-6045
US

IV. Provider business mailing address

1351 E LINDEN AVE
COEUR D ALENE ID
83814-4621
US

V. Phone/Fax

Practice location:
  • Phone: 208-457-1540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH7190
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC5513
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: