MEDICARE: SCOPE SOCIAL SERVICES AND COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558176933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOPE SOCIAL SERVICES AND COUNSELING

Provider Business Mailing Address
First Line	:	488 BLUE LAKES BLVD N STE 108
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4882
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	488 BLUE LAKES BLVD N STE 108
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4882
Country	:	US
Telephone Number	:	208-513-0699
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUMAYAH ABDULLAH
Credential	:
Telephone Number	:	208-713-0311

Provider Enumeration Date	:	02/11/2025
Last Update Date	:	02/11/2025

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