Individual
SAMUEL BARRY DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
151 N 3RD AVE STE 202B, POCATELLO, ID 83201-6368
(208) 479-7864
(208) 656-7344
Mailing address
738 S 4TH AVE, POCATELLO, ID 83201-6503
(208) 749-3558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8331338
ID
101YM0800X
Mental Health Counselor
Primary
LPC-8901
ID
Other
Enumeration date
06/02/2022
Last updated
08/22/2025
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