Luque, Rosemary Ladacy

Luque, Rosemary Ladacy is an sole proprietor health care provider with primary practice located at 4172 N Creswell Way , Boise ID 83713-2403. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Luque, Rosemary Ladacy can be contacted via phone (208) 863-1404.

Contact Information

Primary practice address
4172 N Creswell Way Boise ID 83713-2403
Phone: (208) 863-1404
Fax: (833) 340-7217
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC-2773 Idaho
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LCPC3480 Idaho

Profile Details

NPI number 1245225879
LBN Legal business name Luque, Rosemary Ladacy
Credentials LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated Jan 12th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245225879 NPPES
Idaho Other 000010140465 REGENCE BLUESHIELD ID #
Idaho Other 200000062851 REGENCE BLUESHIELD ID #
Idaho MEDICAID 7365212 REGENCE BLUESHIELD ID #

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