Organization
JJST ENTERPRISES CORP.
Active
Other names
REXBURG COUNSELING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT KAY ANDERSEN LCPC (OWNER)
(208) 356-0088
Entity
Organization
Contact information
Practice address
343 E 4TH N, SUITE 244, REXBURG, ID 83440-6002
(208) 356-0088
Mailing address
343 E 4TH N, SUITE 244, REXBURG, ID 83440-6002
(208) 356-0088
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-2823
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508870676
BLUE CROSS
ID
05
—
1508870676
—
ID
Enumeration date
11/04/2010
Last updated
11/08/2011
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