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NPI Code Detail

MEDICARE: MS. MERCEDES F RESENDIZ LPC

MEDICARE: MS. MERCEDES F RESENDIZ LPC
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
1101YM0800XMental Health Counselor6261670ID

General Provider Information

NPI Number : 1811729627
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MERCEDES F RESENDIZ LPC
Provider Business Mailing Address
First Line : 947 N RYDE AVE
Second Line :
City : KUNA
State : ID
Zip : 83634-5098
Country : US
Telephone Number : 208-230-3377
Fax Number :
Provider Business Practice Location Address
First Line : 3676 N HARBOR LN STE 100
Second Line :
City : BOISE
State : ID
Zip : 83703-6919
Country : US
Telephone Number : 208-918-2743
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2024
Last Update Date : 05/19/2026

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