Provider Demographics
NPI:1366773020
Name:ARRIETA-RESNICK, NEKANE FELISA (LCPC)
Entity type:Individual
Prefix:MS
First Name:NEKANE
Middle Name:FELISA
Last Name:ARRIETA-RESNICK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N. 6TH STREET, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702
Mailing Address - Country:US
Mailing Address - Phone:208-724-8666
Mailing Address - Fax:208-908-0058
Practice Address - Street 1:223 N. 6TH STREET, SUITE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702
Practice Address - Country:US
Practice Address - Phone:208-724-8666
Practice Address - Fax:208-908-0058
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-5094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1134581150OtherORGANIZATIONAL NPI