=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346411451
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL MEILAND-WEBSTER LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2008
-----------------------------------------------------
Last Update Date | 03/05/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PO BOX 3068 ROOM 200
-----------------------------------------------------
City | BONNERS FERRY
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83805-3068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-267-8182
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1215 MICHIGAN ST STE A
-----------------------------------------------------
City | SANDPOINT
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83864-5014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-209-0535
-----------------------------------------------------
Fax | 208-209-0966
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCSW-28304
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------