Organization
OSTERMILLER COUNSELING SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED RYAN OSTERMILLER LCSW (OWNER MANAGER)
(208) 359-9683
Entity
Organization
Contact information
Practice address
242 E 7TH N STE 4, REXBURG, ID 83440-3550
(208) 359-9683
(208) 359-9683
Mailing address
242 E 7TH N STE 4, REXBURG, ID 83440-3550
(208) 359-9683
(208) 359-9683
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LCSW-1351
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151377
BLUE SHIELD GROUP #
ID
05
—
806530400
—
ID
05
—
806867300
—
ID
01
—
8J059
BLUE CROSS GROUP NUMBER
ID
Enumeration date
04/06/2007
Last updated
03/16/2021
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