Provider Demographics
NPI:1164222618
Name:CHAZOWN COUNSELING LLC
Entity type:Organization
Organization Name:CHAZOWN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIRI
Authorized Official - Middle Name:M
Authorized Official - Last Name:STRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-521-1492
Mailing Address - Street 1:9915 N 26TH E
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-6435
Mailing Address - Country:US
Mailing Address - Phone:208-521-8389
Mailing Address - Fax:208-271-8882
Practice Address - Street 1:9915 N 26TH E
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-6435
Practice Address - Country:US
Practice Address - Phone:208-521-8389
Practice Address - Fax:208-271-8882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAZOWN COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty