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General NPI Number Information
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NPI Number | 1649807298
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Entity Type | Organization
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Legal Business Name | SOS FOR FAMILIES, LLC
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 1810 E SCHNEIDMILLER AVE STE 141
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City | POST FALLS
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State | ID
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Zip | 83854-7989
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Country | US
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Telephone | 208-981-0515
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Fax | 208-981-0514
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Provider Business Mailing Address
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Address Line | 536 S KELLY RD
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City | COEUR D ALENE
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State | ID
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Zip | 83814-7194
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Country | US
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Telephone | 208-640-4339
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | BENNY KELL HENSON
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Credential | LCSW
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Telephone | 208-640-4339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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