Organization Name: | PETTINGILL COUNSELING SERVICES, PC |
NPI Number: | 1194847285 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TAMARA K. PETTINGILL (OWNER) |
Mailing Address: | 2267 Teton Plz Idaho Falls |
State: | ID US |
Postal Code: | 834046486 |
Phone Number: | 2085429919 |
Fax Number: | 2085426272 |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LCSW-24477 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |