EMILY DIANE BERGSTROM LPC NPI 1184254146

NPI Information

NPI: 1184254146
Provider Name: EMILY DIANE BERGSTROM, LPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
2365 N 34TH ST
BOISE, ID
ZIP 83703
Phone: (208) 473-8205
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Emily Diane Bergstrom, LPC is a mental health counselor in Boise, ID. Emily Diane Bergstrom, LPC NPI is 1184254146. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2365 N 34TH ST
BOISE, ID
ZIP 83703-523
Phone: (208) 473-8205

The enumeration date for this NPI number is 1/18/2020 and was last updated on 1/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	LPC-6167	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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