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General NPI Number Information
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NPI Number | 1447695630
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Entity Type | Organization
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Legal Business Name | SUSAN M. BEGLINGER, LTD
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 206 E INDIANA AVE SUITE 112
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2969
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Country | US
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Telephone | 208-777-5510
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Fax | 208-292-4505
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Provider Business Mailing Address
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Address Line | 212 W IRONWOOD DR SUITE D 268
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City | COEUR D ALENE
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State | ID
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Zip | 83814-1403
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Country | US
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Telephone | 208-777-5510
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Fax | 208-292-4505
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | SUSAN MARIE BEGLINGER
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Credential | LMFT
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Telephone | 208-777-5510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LMFT3898
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | LMFT 3898
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License Number State | ID
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