Provider Demographics
NPI:1083325872
Name:ANGELA MACDONALD-HERTZ LLC
Entity Type:Organization
Organization Name:ANGELA MACDONALD-HERTZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:208-807-6499
Mailing Address - Street 1:2816 E LIMESTONE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-6233
Mailing Address - Country:US
Mailing Address - Phone:208-807-6499
Mailing Address - Fax:
Practice Address - Street 1:2816 E LIMESTONE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6233
Practice Address - Country:US
Practice Address - Phone:208-807-6499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty