=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699257568
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CALEB JESSE ORR LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2018
-----------------------------------------------------
Last Update Date | 04/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1033 BALDY MOUNTAIN RD
-----------------------------------------------------
City | SANDPOINT
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83864-9202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-920-5151
-----------------------------------------------------
Fax | 208-255-5635
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 SIXTH AVE
-----------------------------------------------------
City | SANDPOINT
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83864-5396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-263-7101
-----------------------------------------------------
Fax | 208-255-5635
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC-6923
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------