Provider Demographics
NPI:1902672413
Name:REIHER, CHAD JAY (CADC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:JAY
Last Name:REIHER
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:CHAD
Other - Middle Name:JAY
Other - Last Name:REIHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CADC
Mailing Address - Street 1:12780M MARNA ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-4519
Mailing Address - Country:US
Mailing Address - Phone:986-200-5540
Mailing Address - Fax:
Practice Address - Street 1:524 S 9TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5072
Practice Address - Country:US
Practice Address - Phone:208-454-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID11757101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)