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Organization
CREEKSIDE COUNSELING
Active
Organization
CREEKSIDE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET O. ALLEN ED.D, LCPC (CLINICAL DIRECTOR)
(208) 529-5777
Entity
Organization
Contact information
Practice address
550 W SUNNYSIDE RD STE 1, IDAHO FALLS, ID 83402-4619
(208) 529-5777
(208) 529-5778
Mailing address
550 W SUNNYSIDE RD STE 1, IDAHO FALLS, ID 83402-4619
(208) 529-5777
(208) 529-5778
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP1094A
ID
Other
Enumeration date
12/14/2006
Last updated
10/15/2013
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