Healthcare Provider Details

I. General information

NPI: 1881978617
Provider Name (Legal Business Name): JOHN C DEWIG LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 642
POST FALLS ID
83877-0642
US

IV. Provider business mailing address

PO BOX 642
POST FALLS ID
83877-0642
US

V. Phone/Fax

Practice location:
  • Phone: 208-603-9946
  • Fax:
Mailing address:
  • Phone: 208-603-9946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1261577
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: