MEDICARE: HELPING HEARTS COUNSELING CENTER, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L8067	OTHER	IL	BLUE CROSS OF IDAHO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942808019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING HEARTS COUNSELING CENTER, PLLC

Provider Business Mailing Address
First Line	:	310 CLEVELAND BLVD # 310
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-3624
Country	:	US
Telephone Number	:	208-954-0597
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 CLEVELAND BLVD
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-3624
Country	:	US
Telephone Number	:	120-895-4059
Fax Number	:

Authorized Official
Title or Position	:	CEO, CLINICAL DIRECTOR/THERAPIST
Name	:	MRS. YOLANDA AMBER PONDER
Credential	:	LCSW
Telephone Number	:	208-954-0597

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

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