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General NPI Number Information
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NPI Number | 1508983925
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Entity Type | Organization
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Legal Business Name | A NEW HORIZON COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10615 N GOVERNMENT WAY SUITE 206
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City | HAYDEN
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State | ID
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Zip | 83835-7473
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Country | US
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Telephone | 208-755-5188
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Fax | 208-772-2533
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Provider Business Mailing Address
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Address Line | 10615 N GOVERNMENT WAY SUITE 206
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City | HAYDEN
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State | ID
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Zip | 83835-7473
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Country | US
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Telephone | 208-755-5188
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Fax | 208-772-2533
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. TERRI LYNN SUDOL
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Credential | M.S.W., L.C.S.W.
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Telephone | 208-755-5188
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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 | LCSW-1215
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License Number State | ID
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