Ontaya Acedo, LMSW
Social Worker, Clinical in Pocatello, ID. Individual provider (NPI-1).
NPI number1104436062
StatusActive
Last updated in NPPESMar 31, 2025
Details
- NPI
- 1104436062
- Entity type
- Individual (NPI-1)
- Name
- Ontaya Acedo
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2020
- Certification date
- Mar 31, 2025
- Last updated
- Mar 31, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 8861355 | ID | Yes |
| 104100000X | Social Worker | LMSW-39736 | ID |
Practice location
151 N 3rd Ave Ste 330Pocatello, ID 83201-6369
Phone 208-242-3771
Mailing address
151 N 3rd Ave Ste 330Pocatello, ID 83201-6369
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