Healthcare Provider Details

I. General information

NPI: 1093649493
Provider Name (Legal Business Name): ENSO RISING THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6477 W FAIRVIEW AVE STE B
BOISE ID
83704-7717
US

IV. Provider business mailing address

6477 W FAIRVIEW AVE STE B
BOISE ID
83704-7717
US

V. Phone/Fax

Practice location:
  • Phone: 208-451-3050
  • Fax:
Mailing address:
  • Phone: 208-451-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH KRISTINA ERICKSON
Title or Position: OWNER/CEO
Credential: LCSW
Phone: 208-451-3050