| Organization Name: | CLEARWATER COUNSELING |
| NPI Number: | 1760503676 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK R JONES (OWNER) |
| Mailing Address: | 318 E. Main Grangeville |
| State: | ID US |
| Postal Code: | 83530 |
| Phone Number: | 2089837717 |
| Fax Number: | 2089837787 |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 04/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |