Organization
CLEARWATER COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R JONES LCSW (OWNER)
(208) 743-8101
Entity
Organization
Contact information
Practice address
318 E. MAIN, GRANGEVILLE, ID 83530
(208) 983-7717
(208) 983-7787
Mailing address
P.O. BOX 1123, LEWISTON, ID 83504
(208) 743-8101
(208) 746-7402
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8073465
—
ID
Enumeration date
04/02/2007
Last updated
04/20/2009
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