| Doctor Name: | DR. DAVID ALLEN INGEBRITSEN |
| NPI Number: | 1538158829 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD LCPC |
| License Number: | LCPC228 |
| Business Practice Address: | 1115 B Street Plummer, ID - 83851 |
| Business Phone Number: | 2086861449 |
| Business Fax Number: | 2086865813 |
| Mailing Address: | Po Box 388, PLUMMER |
| State: | ID |
| Postal Code: | 83851 |
| Phone Number: | 2086861449 |
| Fax Number: | 2086865813 |
| NPI Enumeration Date: | 10/19/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LCPC228 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |