NPI 1336316207

Mountain Lake Counseling and Support Services, INC.

Organisation Community/Behavioral Health Agency Sandpoint, ID

Practice location

Address: 804 Airport Way, Sandpoint, ID 83864-8200
Phone: (208) 597-3553

Authorised official

Name: M. Mikell Zimmerman
Title: President
Phone: (208) 597-3553

Registered specialties (2)

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence LPC-3664 (ID)

Other Community/Behavioral Health providers in Idaho →

Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence LPC-3664 (ID)

Other Counselor providers in Idaho →

Registry record

NPI: 1336316207
Entity type: Organization
NPI issued: 9 May 2008
Record last updated: 9 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.