Provider Demographics
NPI:1659106441
Name:CDA COUNSELING SERVICES
Entity type:Organization
Organization Name:CDA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SMEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:509-989-4935
Mailing Address - Street 1:3675 N SCOTCH PINE LN APT 3
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-1899
Mailing Address - Country:US
Mailing Address - Phone:509-989-4935
Mailing Address - Fax:208-601-6162
Practice Address - Street 1:5920 N GOVERNMENT WAY STE 4
Practice Address - Street 2:
Practice Address - City:DALTON GARDENS
Practice Address - State:ID
Practice Address - Zip Code:83815-9200
Practice Address - Country:US
Practice Address - Phone:509-989-4935
Practice Address - Fax:208-601-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty