Healthcare Provider Details

I. General information

NPI: 1588303143
Provider Name (Legal Business Name): ELIZABETH GIRNDT-STRONG LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 E RIVERPARK LN STE 220
BOISE ID
83706-6559
US

IV. Provider business mailing address

671 E RIVERPARK LN STE 220
BOISE ID
83706-6559
US

V. Phone/Fax

Practice location:
  • Phone: 208-344-2071
  • Fax: 208-344-2075
Mailing address:
  • Phone: 208-344-2071
  • Fax: 208-344-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-10420
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: