Organization
SUMMIT CREEK COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE BARNES LPC (MANAGER/MEMBER)
(208) 220-6534
Entity
Organization
Contact information
Practice address
57 BANNOCK ST, MALAD CITY, ID 83252-1240
(208) 220-6534
Mailing address
PO BOX 35, DOWNEY, ID 83234-0035
(208) 220-6534
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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