Healthcare Provider Details

I. General information

NPI: 1437080884
Provider Name (Legal Business Name): SYNERGISTIC HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2537 W STATE ST STE 110
BOISE ID
83702-2200
US

IV. Provider business mailing address

PO BOX 5222
BOISE ID
83705-0222
US

V. Phone/Fax

Practice location:
  • Phone: 208-924-3513
  • Fax:
Mailing address:
  • Phone: 208-924-3513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RONIA JORDAN
Title or Position: OWNER/THERAPIST
Credential:
Phone: 208-590-3218