LAKE CITY COUNSELING CENTER LLC (NPI# 1720513963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720513963 |
| Entity Type | Organization |
| Organization Name | LAKE CITY COUNSELING CENTER LLC |
| Practice Address |
9705 N Shaw St Hayden ID 83835-9716 |
| Practice Telephone | 2086259981 |
| Mailing Telephone | 2088192716 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | JENNIFER RIAN TUTTLE (OWNER) |
| Authorized Official Telephone | 2088192716 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | IDTPID013454 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 118 N 7th St Ste C2, Coeur D Alene, ID 838142763 | 2088192716 |
| Street Address |
9705 N SHAW ST |
| City | HAYDEN |
| State | ID |
| Zip Code | 83835-9716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609158781 | Jennifer Rian Tuttle | Social Worker | 9705 N Shaw St, Hayden, ID 83835-9716 | 2011-09-14 |
| 1972143048 | Lake City Counseling Center | Community/Behavioral Health | 9705 N Shaw St, Hayden, ID 83835-9716 | 2020-01-07 |
| 1962042036 | Lake City Counseling Center | Case Management | 9705 N Shaw St, Hayden, ID 83835-9716 | 2020-01-07 |
| 1356981419 | Lake City Counseling Center | Peer Specialist | 9705 N Shaw St, Hayden, ID 83835-9716 | 2020-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881212371 | Ngan T Nguyen | Pharmacist | 161 E. Prairie Shopping Center, Hayden, ID 83835 | 2020-07-10 |
| 1689158461 | Rskiom, Pllc | Electrodiagnostic Medicine | 9323 N Government Way #6, Hayden, ID 83835 | 2018-09-18 |
| 1235616913 | Kimberly Jill Young | Dietitian, Registered | 8500 N. Atlas Rd., Hayden, ID 83835 | 2018-07-25 |
| 1851894380 | Medicine Man North Pharmacy Inc | Pharmacy | 30585 N Roberts Rd, Hayden, ID 83835 | 2018-03-11 |
| 1366997322 | Jennifer Amber Belmont | Social Worker | 8680 N Wayne Dr, Suite A, Hayden, ID 83835 | 2016-08-19 |
| 1548637994 | Dance Dentistry Pllc | Clinic/Center | 1027 W Prairie Ave, Hayden, ID 83835 | 2015-09-01 |
| 1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1669812301 | Caleb Jerome Foss | Physical Therapist | 8382 N Wayne Dr Ste 100, Hayden, ID 83835 | 2013-06-26 |
| 1437493798 | Joseph Neal Tessendorf | Chiropractor | 1401 Biztown Loop, Hayden, ID 83835 | 2012-11-26 |
| Find all providers in zip 83835 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194383018 | Kateri Picard Ray | Social Worker | 1302 W Starling Ave, Hayden, ID 83835-8851 | 2019-06-05 |
| 1609158781 | Jennifer Rian Tuttle | Social Worker | 9705 N Shaw St, Hayden, ID 83835-9716 | 2011-09-14 |
| 1891950754 | Brigette D Hager | Social Worker | 1130 W Hayden Ave, Suite 201, Hayden, ID 83835-8720 | 2008-07-21 |
| 1316001621 | Terri Lynn Sudol | Social Worker | 10615 N Government Way Ste 206, Hayden, ID 83835-8027 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171961 | Jill Michelle Chonody | Social Worker | 3134 S Waterbury Ln, Boise, ID 83706-5222 | 2020-10-09 |
| 1750999777 | Deanna Armenia Brent | Social Worker | 7450 W Althea Ct, Boise, ID 83709-1777 | 2020-07-15 |
| 1164040820 | Sylinda Lee Mendenhall | Social Worker | 771 S Jafer Court, Idaho Falls, ID 83401-8404 | 2020-07-09 |
| 1013533231 | Sylvia Oh | Social Worker | 2118 S Latah St, Boise, ID 83705-3947 | 2020-06-23 |
| 1073135851 | Kimberly Ruth Carey | Social Worker | 6160 Dallas Ln, Bonners Ferry, ID 83805-9794 | 2020-05-14 |
| 1497377469 | Raising Resilience Holistic Mental Wellness Inc | Social Worker | 610 W Hubbard St Ste 226, Coeur D Alene, ID 83814-2200 | 2020-05-13 |
| 1417577412 | Stacey Titus Pllc | Social Worker | 5440 W Franklin Rd Ste 201, Boise, ID 83705-6434 | 2020-04-20 |
| 1922627314 | Taresa Dawn Crow | Social Worker | 3655 Samuel St, Ammon, ID 83406-7822 | 2020-04-15 |
| 1447888656 | Berndt and Associates In Psychcare LLC | Social Worker | 4477 W Emerald St Ste C275, Boise, ID 83706-2078 | 2020-04-01 |
| 1467086603 | Abundant Serenity LLC | Social Worker | 925 N Main St Ste A, Meridian, ID 83642-2301 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.