Beachside Counseling LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Coeur D Alene, ID. Organization (NPI-2).
NPI number1104599331
StatusActive
Last updated in NPPESOct 14, 2022
Details
- NPI
- 1104599331
- Entity type
- Organization (NPI-2)
- Legal business name
- Beachside Counseling LLC
- Organization subpart
- No
- Enumeration date
- Jul 24, 2021
- Certification date
- Oct 14, 2022
- Last updated
- Oct 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
1250 W Ironwood Dr Ste 330Coeur D Alene, ID 83814-2682
Phone 208-964-4523
Mailing address
1250 W Ironwood Dr Ste 330Coeur D Alene, ID 83814-2682
Phone 208-274-3020
Authorized official
Rebecca Bradley
Licensed Professional Counselor
2082743020
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