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Organization

ALPINE INTEGRATED WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL JACOB ROTHMAN MA, LCPC (EXECUTIVE DIRECTOR)
(503) 936-0379
Entity
Organization

Contact information

Practice address
220 RIVER ST E, SUITE D, KETCHUM, ID 83340
(503) 936-0379
(413) 677-2481
Mailing address
PO BOX 533, KETCHUM, ID 83340-0481
(503) 936-0379
(413) 677-2481

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
01/13/2020
Last updated
04/21/2026
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