Healthcare Provider Details

I. General information

NPI: 1003368044
Provider Name (Legal Business Name): DUSTI MARIE HUDDLESTON MA, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 S CLEARWATER LOOP STE R
POST FALLS ID
83854-9599
US

IV. Provider business mailing address

784 S CLEARWATER LOOP STE R
POST FALLS ID
83854-9599
US

V. Phone/Fax

Practice location:
  • Phone: 208-568-1437
  • Fax:
Mailing address:
  • Phone: 208-568-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-40860
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: