Organization
EMMETT FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S LEE LCSW, LMHP (CO-OWNER)
(208) 559-7773
Entity
Organization
Contact information
Practice address
501 N 16TH ST, STE 108 & 110, PAYETTE, ID 83661-2781
(208) 642-2600
(208) 642-6164
Mailing address
501 N 16TH ST, STE 108 & 110, PAYETTE, ID 83661-2781
(208) 642-2600
(208) 642-6164
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
26695
ID
1041C0700X
Clinical Social Worker
Primary
24210
ID
363LF0000X
Family Nurse Practitioner
446A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806575100
—
ID
05
—
806586200
—
ID
Enumeration date
12/21/2006
Last updated
09/28/2010
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