MEDICARE: KRISTY ANN PENDLETON LCSW

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	LCSW-34365	ID

General Provider Information

NPI Number	:	1659797090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY ANN PENDLETON LCSW

Provider Business Mailing Address
First Line	:	3656 E VISION DR
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83401-5045
Country	:	US
Telephone Number	:	208-313-7449
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 E 17TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-6273
Country	:	US
Telephone Number	:	208-538-3122
Fax Number	:	208-881-5295

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	12/03/2020

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1669480091 — DR. AARON A HARRIS PHD
Practice Location Address:

1301 E 17TH ST
IDAHO FALLS, ID
83404-6273

Practice Phone: 406-848-4906
Practice Fax:

1285979757 — AAA AMERICAN HEALTHCARE LLC
Practice Location Address:

1301 E 17TH ST
IDAHO FALLS, ID
83404-6273

Practice Phone: 208-538-3122
Practice Fax:

1245670793 — ASHTON MEMORIAL, INC.
Practice Location Address:

1301 E 17TH ST STE 4
IDAHO FALLS, ID
83404-6273

Practice Phone: 208-523-0787
Practice Fax: 208-523-3175

1912378787 — AAA AMERICAN HEALTHCARE LLC
Practice Location Address:

1301 E 17TH ST STE 5
IDAHO FALLS, ID
83404-6273

Practice Phone: 208-538-3122
Practice Fax:

1942836911 — AMERICA HEALTH INC
Practice Location Address:

1301 E 17TH ST
IDAHO FALLS, ID
83404-6273

Practice Phone: 208-538-3122
Practice Fax:

Directions to “ KRISTY ANN PENDLETON LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.