Provider Demographics
NPI:1598814477
Name:RHINEHART, KEVIN PAUL (MSW)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:PAUL
Last Name:RHINEHART
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3631 OVERLAND
Mailing Address - Street 2:CHRISTIAN COUNSELING CENTER
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705
Mailing Address - Country:US
Mailing Address - Phone:208-343-0441
Mailing Address - Fax:208-343-4993
Practice Address - Street 1:3631 OVERLAND
Practice Address - Street 2:CHRISTIAN COUNSELING CENTER
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705
Practice Address - Country:US
Practice Address - Phone:208-343-0441
Practice Address - Fax:208-343-4993
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW6121041C0700X
IDLMFT2705106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist