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General NPI Number Information
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NPI Number | 1588010615
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Entity Type | Organization
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Legal Business Name | FAMILY HARMONY, LLC
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Dates
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Enumeration Date | 05/07/2016
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Last Update Date | 05/07/2016
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Provider Practice Location Address
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Address Line | 2922 CLEVELAND BLVD SUITE 500
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City | CALDWELL
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State | ID
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Zip | 83605-4436
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Country | US
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Telephone | 208-453-2728
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Fax | 208-455-1474
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Provider Business Mailing Address
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Address Line | 2922 CLEVELAND BLVD SUITE 500
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City | CALDWELL
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State | ID
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Zip | 83605-4436
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Country | US
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Telephone | 208-453-2728
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Fax | 208-455-1474
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Authorized Official
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Title or Position | CEO/ CLINICAIN
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Name | ELIZABETH MCDOUGALL
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Credential | LCSW
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Telephone | 208-453-2728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCSW-29269
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License Number State | ID
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