Healthcare Provider Details

I. General information

NPI: 1073174595
Provider Name (Legal Business Name): SEVEN PEAKS COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N FOURTH AVE STE 103
SANDPOINT ID
83864-1360
US

IV. Provider business mailing address

101 N FOURTH AVE STE 103
SANDPOINT ID
83864-1360
US

V. Phone/Fax

Practice location:
  • Phone: 208-920-5600
  • Fax: 208-298-3837
Mailing address:
  • Phone: 208-920-5600
  • Fax: 208-298-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE M PERUSSE
Title or Position: OWNER/CLINICIAN
Credential: LCPC
Phone: 208-920-5600