MEDICARE: BLUE CELINE STOEHR MA

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	106H00000X	Marriage & Family Therapist	LMFT-8080	ID
2	106H00000X	Marriage & Family Therapist	51400	CA

General Provider Information

NPI Number	:	1417167008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLUE CELINE STOEHR MA

Provider Business Mailing Address
First Line	:	2494 E BRIERFIELD DR
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-6617
Country	:	US
Telephone Number	:	747-229-4299
Fax Number	:

Provider Business Practice Location Address
First Line	:	1065 E WINDING CREEK DR
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-7243
Country	:	US
Telephone Number	:	747-229-4299
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	04/06/2026

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Directions to “ BLUE CELINE STOEHR MA” Practice Location

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