Individual
RICHARD MORSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 E 16TH ST, IDAHO FALLS, ID 83404-5919
(208) 523-6727
(208) 523-6729
Mailing address
115 E 16TH ST, IDAHO FALLS, ID 83404-5919
(208) 523-6727
(208) 523-6729
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-36568
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-0471763
MEDICARE PTAN: 20006011
ID
Enumeration date
05/07/2017
Last updated
05/07/2017
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