Healthcare Provider Details

I. General information

NPI: 1578628749
Provider Name (Legal Business Name): BEHAVIORAL HEALTH ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E RIVERPARK LN STE 200
BOISE ID
83706
US

IV. Provider business mailing address

600 E RIVERPARK LN STE 200
BOISE ID
83706
US

V. Phone/Fax

Practice location:
  • Phone: 208-344-5457
  • Fax: 208-343-5165
Mailing address:
  • Phone: 208-344-5457
  • Fax: 208-343-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLY M ARENDT
Title or Position: PARTNER
Credential: LCPC
Phone: 208-344-5457