Provider Demographics
NPI:1962618959
Name:METHODIST COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:METHODIST COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HOADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:208-343-7511
Mailing Address - Street 1:717 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5365
Mailing Address - Country:US
Mailing Address - Phone:208-343-7511
Mailing Address - Fax:208-343-0000
Practice Address - Street 1:717 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5365
Practice Address - Country:US
Practice Address - Phone:208-343-7511
Practice Address - Fax:208-343-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health