Organization
STILLWATER CONNECTION
Active
Other names
Middleton Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANYA KRISTEN NELSON (OWNER)
(208) 800-2758
Entity
Organization
Contact information
Practice address
22480 DUFF LN, MIDDLETON, ID 83644-6041
(208) 965-4502
(208) 505-4280
Mailing address
22480 DUFF LN, MIDDLETON, ID 83644-6041
(208) 965-4502
(208) 505-4280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
LPC6027
ID
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457867962
—
ID
Enumeration date
12/19/2017
Last updated
03/29/2024
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