Provider Demographics
NPI:1447695630
Name:SUSAN M. BEGLINGER, LTD
Entity type:Organization
Organization Name:SUSAN M. BEGLINGER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BEGLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:208-777-5510
Mailing Address - Street 1:212 W IRONWOOD DR
Mailing Address - Street 2:SUITE D 268
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-1403
Mailing Address - Country:US
Mailing Address - Phone:208-777-5510
Mailing Address - Fax:208-292-4505
Practice Address - Street 1:206 E INDIANA AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2969
Practice Address - Country:US
Practice Address - Phone:208-777-5510
Practice Address - Fax:208-292-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMFT3898261QM0850X
IDLMFT 3898261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health