Provider Demographics
NPI:1457517567
Name:HALBERT, DORI LIN (LCPC)
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:LIN
Last Name:HALBERT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-8867
Mailing Address - Country:US
Mailing Address - Phone:208-880-0720
Mailing Address - Fax:
Practice Address - Street 1:4170 E AMITY AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-8802
Practice Address - Country:US
Practice Address - Phone:208-465-4985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 4061101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health