Provider Demographics
NPI:1124590302
Name:A PENNEY FOR YOUR THOUGHTS
Entity Type:Organization
Organization Name:A PENNEY FOR YOUR THOUGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PENNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKHILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-419-6102
Mailing Address - Street 1:1820 E 17TH ST STE 190
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6518
Mailing Address - Country:US
Mailing Address - Phone:208-419-6102
Mailing Address - Fax:208-549-9618
Practice Address - Street 1:1820 E 17TH ST STE 190
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6518
Practice Address - Country:US
Practice Address - Phone:208-419-6102
Practice Address - Fax:208-549-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty