MEDICARE: MRS. JULIA CLAIRE WOOD LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	4362	ID

General Provider Information

NPI Number	:	1215213822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIA CLAIRE WOOD LCPC

Provider Business Mailing Address
First Line	:	2711 N MCKINNEY ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-6023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7737 NORTHVIEW STREET
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-7360
Country	:	US
Telephone Number	:	208-841-2098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2011
Last Update Date	:	01/21/2025

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