Healthcare Provider Details

I. General information

NPI: 1588939839
Provider Name (Legal Business Name): ANUSARA WRIGHT LCPC-6986
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 S ORCHARD ST STE 100
BOISE ID
83705-1916
US

IV. Provider business mailing address

921 S ORCHARD ST STE 100
BOISE ID
83705-1916
US

V. Phone/Fax

Practice location:
  • Phone: 208-344-9797
  • Fax: 208-344-9898
Mailing address:
  • Phone: 208-344-9797
  • Fax: 208-344-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-6986
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: