Individual provider · Type 1 NPI

Shawn Robert Israelsen, LCSW

Professional Counselor · Idaho Falls, ID

NPI number 1629679048 Active

Practice location

2265 W Broadway St
Idaho Falls, ID 83402-2996

Call (208) 524-7400 Map

Fax (208) 534-8004

Mailing address

2275 W. Broadway St #G
Idaho Falls, ID 83402-2902

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XLMSW-18733 (AZ)
Social Worker 104100000XLMSW-40331 (ID)
Clinical Social Worker 1041C0700X8722060-3502 (UT)
Clinical Social Worker 1041C0700X8722060-3502CSW (UT)
Professional Counselor Primary 101YP2500XLCSW-44276 (ID)

Professional Counselor: Definition to come...

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About NPI 1629679048

Shawn Robert Israelsen, LCSW's National Provider Identifier is 1629679048, issued on Nov 3, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Idaho Falls, ID. The record was last updated on Oct 18, 2023.