Organization
CLEARWATER COUNSELING
Active
Parent organization
CLEARWATER COUNSELING
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEARWATER COUNSELING
Authorized official
MR. MARK ROBERT JONES LCSW (OWNER)
(208) 743-8101
Entity
Organization
Contact information
Practice address
318 1/2 E MAIN ST, GRANGEVILLE, ID 83530-2238
(208) 983-7717
(208) 983-7787
Mailing address
1020 MAIN ST, PO BOX 1123, LEWISTON, ID 83501-1842
(208) 743-8101
(208) 746-7402
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LCPC4218
ID
261QM0850X
Adult Mental Health Clinic/Center
LCSW1120
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807373700
—
ID
Enumeration date
04/03/2009
Last updated
04/03/2009
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