Provider Demographics
NPI:1275091167
Name:REFLECTIONS COUNSELING AND LIFE COACHING LLC
Entity Type:Organization
Organization Name:REFLECTIONS COUNSELING AND LIFE COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:509-480-8620
Mailing Address - Street 1:550 LARKSPUR ST APT E313
Mailing Address - Street 2:
Mailing Address - City:PONDERAY
Mailing Address - State:ID
Mailing Address - Zip Code:83852-5068
Mailing Address - Country:US
Mailing Address - Phone:509-480-8620
Mailing Address - Fax:
Practice Address - Street 1:11287 N BOYER RD
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-8860
Practice Address - Country:US
Practice Address - Phone:509-480-8620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-09
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty