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Ms. Tamara K. Pettingill, LCSW
Counselor in Idaho Falls, Idaho
NPI 1629081864

Tamara K. Pettingill is a Counselor based in Idaho Falls, ID. Tamara K. Pettingill practices in Idaho Falls, ID and has the professional credentials of LCSW. The NPI Number for Tamara K. Pettingill is 1629081864 and holds a License No. (Idaho).

The current practice location address for Tamara K. Pettingill is 1302 E 17Th St, Idaho Falls, ID and can be reached out via phone at 208-542-9199 and via fax at 208-542-6272.

Location: 1302 E 17Th St, Idaho Falls, ID, 83404-6270
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Provider Profile Details
NPI Number
1629081864
Provider Name
Tamara K. Pettingill
Credential
LCSW
Provider Entity Type
Individual
Gender
Female
Address
1302 E 17Th St, Idaho Falls, ID, 83404-6270
Phone Number
208-542-9199
Fax Number
208-542-6272
Provider Enumeration Date
08/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
806864000 05 ID
806836700 05 ID
806803500 05 ID
institution
Provider Business Practice Location Address Details
Address
1302 E 17Th St
City
State
Zip
83404-6270
Phone Number
208-542-9199
Fax Number
208-542-6272
person
Provider Business Mailing Address Details
Address
1302 E 17Th St
City
State
Zip
83404-6270
Phone Number
208-542-9199
Fax Number
208-542-6272
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
LCSW-24477 (Idaho)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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