Provider Demographics
NPI:1073842266
Name:GEISSLER, PETER SCOTT (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:SCOTT
Last Name:GEISSLER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 S CLEARWATER LOOP STE 4067
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9599
Mailing Address - Country:US
Mailing Address - Phone:208-219-5285
Mailing Address - Fax:
Practice Address - Street 1:784 S CLEARWATER LOOP STE 4067
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9599
Practice Address - Country:US
Practice Address - Phone:208-219-5285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00055828101Y00000X
DCADD14039101YA0400X
OR10129152101Y00000X
FLMH8935101YM0800X
CARP-254102L00000X
DCLMFT000063106H00000X
TN842106H00000X
261QM2500X
TN1059101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty