Healthcare Provider Details

I. General information

NPI: 1750244752
Provider Name (Legal Business Name): SAMANTHA A PIRNIE MS, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA A BODINE MS, CADC

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 W CLAUDIA RD
BOISE ID
83714-8007
US

IV. Provider business mailing address

10305 W CLAUDIA RD
BOISE ID
83714-8007
US

V. Phone/Fax

Practice location:
  • Phone: 208-286-4274
  • Fax: 208-286-4292
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12944
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: