Provider Demographics
NPI:1992924500
Name:SITMAN, INC.
Entity type:Organization
Organization Name:SITMAN, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ELKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-732-6112
Mailing Address - Street 1:202 2ND AVE N STE B
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6158
Mailing Address - Country:US
Mailing Address - Phone:208-732-6112
Mailing Address - Fax:208-732-6116
Practice Address - Street 1:202 2ND AVE N STE B
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6158
Practice Address - Country:US
Practice Address - Phone:208-732-6112
Practice Address - Fax:208-732-6116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-26169101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8M880OtherBLUE CROSS OF IDAHO