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General NPI Number Information
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NPI Number | 1841885266
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Entity Type | Organization
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Legal Business Name | MOUNTAIN WEST BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 222 SHOSHONE ST E
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City | TWIN FALLS
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State | ID
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Zip | 83301-6163
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Country | US
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Telephone | 208-370-8288
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Fax | 888-704-6850
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Provider Business Mailing Address
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Address Line | 222 SHOSHONE ST E
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City | TWIN FALLS
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State | ID
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Zip | 83301-6163
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Country | US
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Telephone | 208-370-8288
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Fax | 888-704-6850
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | ALEXIS PEARSON
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Credential | LCSW
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Telephone | 208-286-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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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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