Provider Demographics
NPI:1598211781
Name:GARN, PAUL RICHARD (LCPC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:RICHARD
Last Name:GARN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 FALLS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3372
Mailing Address - Country:US
Mailing Address - Phone:208-837-1553
Mailing Address - Fax:
Practice Address - Street 1:218 FALLS AVE STE A
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3372
Practice Address - Country:US
Practice Address - Phone:208-837-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-7083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional