Healthcare Provider Details

I. General information

NPI: 1699257568
Provider Name (Legal Business Name): CALEB JESSE ORR LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 BALDY MOUNTAIN RD
SANDPOINT ID
83864-9202
US

IV. Provider business mailing address

810 SIXTH AVE
SANDPOINT ID
83864-5396
US

V. Phone/Fax

Practice location:
  • Phone: 208-920-5151
  • Fax: 208-255-5635
Mailing address:
  • Phone: 208-263-7101
  • Fax: 208-255-5635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-6923
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: