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Individual

INGA L ELKIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED, LCPC

Contact information

Practice address
202 2ND AVE N STE B, TWIN FALLS, ID 83301-6158
(208) 308-4012
(208) 732-6116
Mailing address
202 2ND AVE N STE B, TWIN FALLS, ID 83301-6158
(208) 308-4012
(208) 732-6116

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-3472
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010149104
BLUESHIELD PROVIDER #
ID
01
Q7365
PROVIDER # FOR CLINIC
ID
Enumeration date
11/28/2006
Last updated
07/08/2007
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