Lake City Counseling Center LLC

NPI #1720513963 in Hayden, Idaho

Provider Information

NPI Number: 1720513963
Entity Type: Organization
Organization Name: Lake City Counseling Center LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Apr 25, 2017
Last Updated: Jul 6, 2020

Practice Location

Address: 9705 N SHAW ST
City: Hayden
State: Idaho
ZIP Code: 83835-9716
Phone: (208) 625-9981

Authorized Official

Name: JENNIFER RIAN TUTTLE
Title: OWNER
Phone: (208) 819-2716

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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