Provider Demographics
NPI:1417092412
Name:OHRSTROM, HILDING E JR (LCPC, ACADC, CCS)
Entity Type:Individual
Prefix:MR
First Name:HILDING
Middle Name:E
Last Name:OHRSTROM
Suffix:JR
Gender:M
Credentials:LCPC, ACADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:PRIEST RIVER
Mailing Address - State:ID
Mailing Address - Zip Code:83856-0572
Mailing Address - Country:US
Mailing Address - Phone:208-370-2010
Mailing Address - Fax:208-370-2011
Practice Address - Street 1:1218 N DIVISION AVE STE 104
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-5054
Practice Address - Country:US
Practice Address - Phone:208-370-2010
Practice Address - Fax:208-370-2011
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-3830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional