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General NPI Number Information
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NPI Number | 1174010573
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Entity Type | Organization
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Legal Business Name | KH COUNSELING & HEALTH CENTER, LLC
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 101 EMPTY SADDLE TRL STE 120
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City | HAILEY
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State | ID
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Zip | 83333-8437
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Country | US
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Telephone | 208-720-2049
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Fax |
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Provider Business Mailing Address
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Address Line | 101 EMPTY SADDLE TRL STE 120
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City | HAILEY
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State | ID
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Zip | 83333-8437
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY HAYES
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Credential | LCSW
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Telephone | 208-720-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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