Organization
VCC INC
Active
Other names
Valley Community Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLA DEJONG (OWNER)
(208) 736-0695
Entity
Organization
Contact information
Practice address
1092 EASTLAND DR N STE C, TWIN FALLS, ID 83301-8442
(208) 736-0695
(208) 735-2482
Mailing address
1092 EASTLAND DR N STE C, TWIN FALLS, ID 83301-8442
(208) 736-0695
(208) 735-2482
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805272700
—
ID
01
—
805277500
PSR
ID
05
—
805277500
—
ID
01
—
807394700
CLINICAL
ID
05
—
807394700
—
ID
Enumeration date
05/01/2007
Last updated
02/07/2017
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