Search › Pennsylvania › 104100000X
Michael Ide, LSW
NPI 1134387897 · on the registry since 2008 · sole proprietor
Practice
- Address
- 562 Wyoming Avenue
Choices
Kingston, PA 18704 - Phone
- (570) 552-3700
- Fax
- (570) 552-3705
- Organisation at this address
- David Liskov, Md
Luzerne Wyoming Co Mhc#1
Steven R. Kafrissen, Md, Pc
First Hospital Psy Operations Llc
Luzerne Wyoming County Mh Center #1Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 28
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 101YA0400X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-08-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania