Provider Demographics
NPI:1730372129
Name:BILLINGS, PETER D (MS, LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:D
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5038
Mailing Address - Country:US
Mailing Address - Phone:208-830-5059
Mailing Address - Fax:208-367-9242
Practice Address - Street 1:1412 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5038
Practice Address - Country:US
Practice Address - Phone:208-830-5059
Practice Address - Fax:208-367-9242
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2011-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional