Organization
CLEARWATER COUNSELING
Active
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
Update your record
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