MEDICARE: ANABEL NAVARRO 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	101YM0800X	Mental Health Counselor	LPC-4578	ID
2	101YM0800X	Mental Health Counselor	LCPC-5130	ID

General Provider Information

NPI Number	:	1225343296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANABEL NAVARRO LCPC

Provider Business Mailing Address
First Line	:	2976 E. STATE ST. SUITE 120
Second Line	:	#254
City	:	EAGLE
State	:	ID
Zip	:	83616
Country	:	US
Telephone Number	:	208-872-6177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1276 W RIVER ST
Second Line	:	SUITE 100
City	:	BOISE
State	:	ID
Zip	:	83702-7066
Country	:	US
Telephone Number	:	208-338-4699
Fax Number	:

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

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	06/27/2023

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