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General NPI Number Information
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NPI Number | 1932029303
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Entity Type | Organization
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Legal Business Name | MAGIC VALLEY BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 493 EASTLAND DR
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City | TWIN FALLS
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State | ID
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Zip | 83301-7441
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Country | US
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Telephone | 208-494-6824
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Fax | 208-358-9068
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Provider Business Mailing Address
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Address Line | 493 EASTLAND DR
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City | TWIN FALLS
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State | ID
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Zip | 83301-7441
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Country | US
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Telephone | 208-494-6824
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Fax | 208-358-9068
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. KELSIE HENDRICKSON
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Credential | PHD, ABPP
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Telephone | 208-494-6824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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