Healthcare Provider Details

I. General information

NPI: 1922931690
Provider Name (Legal Business Name): SAPPHIRE SHALEEN SCOTT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3295 W ELDER ST STE 117
BOISE ID
83705-4771
US

IV. Provider business mailing address

3295 W ELDER ST STE 117
BOISE ID
83705-4771
US

V. Phone/Fax

Practice location:
  • Phone: 208-818-7407
  • Fax:
Mailing address:
  • Phone: 208-818-7407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3481014
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: