Healthcare Provider Details

I. General information

NPI: 1467383778
Provider Name (Legal Business Name): SADIA ABDULKADIR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 S ORCHARD ST STE 245
BOISE ID
83705-1964
US

IV. Provider business mailing address

1169 N FRAZIER PL
BOISE ID
83704-5104
US

V. Phone/Fax

Practice location:
  • Phone: 208-867-9403
  • Fax: 888-786-4470
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMSW-8281317
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: