Organization
ATROPOS MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE LYN HANSEN (OWNER)
(208) 915-8448
Entity
Organization
Contact information
Practice address
611 WILSON AVE STE 5, POCATELLO, ID 83201-5046
(208) 915-8448
Mailing address
611 WILSON AVE STE 5, POCATELLO, ID 83201-5046
(208) 915-8448
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
04/29/2024
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