Healthcare Provider Details

I. General information

NPI: 1083907620
Provider Name (Legal Business Name): JOANNE NEARMAN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S LATAH ST STE 108
BOISE ID
83705-2239
US

IV. Provider business mailing address

5061 N MOUNTAIN VIEW DR
BOISE ID
83704-2313
US

V. Phone/Fax

Practice location:
  • Phone: 208-871-6093
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-5505
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: