NPI 1417597683 · live from the CMS NPI Registry
A Victors Gathering Counseling Service
Social Worker, Clinical in Moscow, ID. National Provider Identifier 1417597683, active.
NPI record
| NPI | 1417597683 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 417 E Veatch St, Moscow, ID 83843 |
| Practice phone | 208-874-7989 |
| Enumerated | January 15, 2020 |
| Last updated | December 13, 2023 |
| Authorized official | Kristine Lopez, Therapist/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.