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General NPI Number Information
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NPI Number | 1417092412
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Entity Type | Individual
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Provider Name | HILDING E OHRSTROM JR. LCPC, ACADC, CCS
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 1218 N DIVISION AVE STE 104
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City | SANDPOINT
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State | ID
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Zip | 83864-5054
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Country | US
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Telephone | 208-370-2010
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Fax | 208-370-2011
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Provider Business Mailing Address
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Address Line | PO BOX 572
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City | PRIEST RIVER
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State | ID
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Zip | 83856-0572
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Country | US
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Telephone | 208-370-2010
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Fax | 208-370-2011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LCPC-3830
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License Number State | ID
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