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General NPI Number Information
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NPI Number | 1255845939
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Entity Type | Organization
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Legal Business Name | POOT COUNSELING, LLC
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1286 W LEISURE DR
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City | HAYDEN
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State | ID
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Zip | 83835-8834
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Country | US
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Telephone | 360-421-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 1286 W LEISURE DR
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City | HAYDEN
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State | ID
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Zip | 83835-8834
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Country | US
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Telephone | 360-421-2520
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. BETSY DALE POOT
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Credential | ARNP
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Telephone | 360-421-2520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH00005703
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP30006966
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License Number State | WA
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