Provider Demographics
NPI:1134846959
Name:DISCOVER WELLNESS
Entity type:Organization
Organization Name:DISCOVER WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-724-4665
Mailing Address - Street 1:2505 N OLD STONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-3834
Mailing Address - Country:US
Mailing Address - Phone:208-724-4665
Mailing Address - Fax:
Practice Address - Street 1:2505 N OLD STONE WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-3834
Practice Address - Country:US
Practice Address - Phone:208-724-4665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty