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General NPI Number Information
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NPI Number | 1295081818
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Entity Type | Organization
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Legal Business Name | ALWAYS A CHILD COUNSELING CORNER
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 3619 N 3400 E
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City | KIMBERLY
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State | ID
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Zip | 83341-5288
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Country | US
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Telephone | 208-731-6347
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95
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City | KIMBERLY
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State | ID
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Zip | 83341-0095
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Country | US
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Telephone | 208-731-6347
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | ANGELA MOONEY
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Credential | LPC
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Telephone | 208-731-6347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC-4925
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License Number State | ID
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