MR. KEVIN LEE PETTUS CCS, ACADC
NPI 1265848717
Counselor - Addiction (Substance Use Disorder) in Challis, Idaho 83226, ID

Q: What is Kevin Pettus's NPI number?

The NPI number for Kevin Pettus is 1265848717. It was assigned to this individual provider in the NPPES registry on July 5, 2014.

Q: What is Kevin Pettus's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Pettus was last updated on September 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 05, 2014

25431 HWY 93, CHALLIS, IDAHO 83226, ID 83226(208) 879-2267 Get Directions Write a Review

NPPES record last updated: September 3, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Kevin Lee Pettus Ccs, Acadc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEVIN LEE PETTUS CCS, ACADC (NPI 1265848717) is an individual addiction (substance use disorder) provider in Challis, Idaho 83226, Idaho, licensed in Idaho (13012) and active in the NPI registry since July 2014. He maintains a secondary practice location in Gooding.

NPPES Registry Identity

NPI1265848717

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. KEVIN LEE PETTUSCredential: CCS, ACADC

Location Address25431 HWY 93Challis, Idaho 83226, ID 83226-8322

Mailing Address397 River DrChallis, ID 83226-4840 · (280) 833-7632 · Fax (208) 879-2089

Phone(208) 879-2267

Sole ProprietorYes

Enumeration DateJuly 5, 2014

Last NPPES UpdateSeptember 3, 2021

NPPES CertifiedSeptember 3, 2021

✔ NPI 1265848717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

Licenses✔ Licensed in ID · 13012✔ Licensed in ID · 12002

25431 HWY 93, Challis, Idaho 83226, ID 83226

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Secondary Practice Location 1

Location 1605 11th Ave EGooding, ID 83330-5368 · Phone (208) 934-8461

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Pettus's NPI number?

The NPI number for Kevin Pettus is 1265848717. It was assigned to this individual provider in the NPPES registry on July 5, 2014.

Where is Kevin Pettus located?

Kevin Pettus practices at 25431 Hwy 93, Challis, Idaho 83226, ID 83226. The listed phone number is (208) 879-2267.

What is Kevin Pettus's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kevin Pettus was last updated on September 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.