Healthcare Provider Details

I. General information

NPI: 1861086977
Provider Name (Legal Business Name): ERIN M EADINGTON LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W MAIN ST STE 111
BOISE ID
83702-7725
US

IV. Provider business mailing address

300 W MAIN ST STE 111
BOISE ID
83702-7725
US

V. Phone/Fax

Practice location:
  • Phone: 208-506-0398
  • Fax:
Mailing address:
  • Phone: 208-506-0398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-8017
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: