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General NPI Number Information
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NPI Number | 1215201462
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Entity Type | Organization
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Legal Business Name | EKNESS & SHERMAN ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/17/2012
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Provider Practice Location Address
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Address Line | 2201 N GOVERNMENT WAY STE K
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3658
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Country | US
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Telephone | 208-661-0093
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 N GOVERNMENT WAY STE K
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3658
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Country | US
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Telephone | 208-661-0093
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEITH EKNESS
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Credential | MSW
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Telephone | 208-661-0093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | LCPC-3803
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW-1270
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License Number State | ID
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