STATE OF MIND COUNSELING AND WELLNESS CENTER NPI 1013277128

NPI Information

NPI: 1013277128
Provider Name: STATE OF MIND COUNSELING AND WELLNESS CENTER
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
141 N PALMETTO AVE UNIT 1626
EAGLE, ID
ZIP 83616
Phone: (208) 939-3999
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STATE OF MIND COUNSELING AND WELLNESS CENTER is an adolescent and children mental health clinic center in Eagle, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. STATE OF MIND COUNSELING AND WELLNESS CENTER NPI is 1013277128. The provider is registered as an organization entity type.

The provider's business location address is:

141 N PALMETTO AVE UNIT 1626
EAGLE, ID
ZIP 83616-066
Phone: (208) 939-3999

The provider's authorized official is Lynda Smith .
The authorized official title is Lpc and has the following contact phone number (208) 602-2293.

The enumeration date for this NPI number is 5/22/2012 and was last updated on 7/27/2012.

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	251S00000X	Community/Behavioral Health		4841	IDAHO	No
2	261QM0850X	Clinic/Center	Adult Mental Health	4841	IDAHO	No
3	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	4841	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: 5/5/2024

NPI Synchronization or Removal

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