Provider Demographics
NPI:1689884108
Name:MICHELLE M RINAS
Entity Type:Organization
Organization Name:MICHELLE M RINAS
Other - Org Name:ASHTON COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RINAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-652-7266
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:ID
Mailing Address - Zip Code:83420-0219
Mailing Address - Country:US
Mailing Address - Phone:208-652-7266
Mailing Address - Fax:208-652-9971
Practice Address - Street 1:580 MAIN ST.
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:ID
Practice Address - Zip Code:83420
Practice Address - Country:US
Practice Address - Phone:208-652-7266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8065237Medicaid