Provider Demographics
NPI:1619311511
Name:CAMAS PROFESSIONAL COUNSELING
Entity Type:Organization
Organization Name:CAMAS PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-983-0235
Mailing Address - Street 1:83 HIGHWAY 95 N
Mailing Address - Street 2:
Mailing Address - City:GRANGEVILLE
Mailing Address - State:ID
Mailing Address - Zip Code:83530-5194
Mailing Address - Country:US
Mailing Address - Phone:208-983-0235
Mailing Address - Fax:208-983-0245
Practice Address - Street 1:83 HIGHWAY 95 N
Practice Address - Street 2:
Practice Address - City:GRANGEVILLE
Practice Address - State:ID
Practice Address - Zip Code:83530-5194
Practice Address - Country:US
Practice Address - Phone:208-983-0235
Practice Address - Fax:208-983-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-31699251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health