Healthcare Provider Details

I. General information

NPI: 1417708249
Provider Name (Legal Business Name): LINCOLN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S FRANKLIN PARK DR
BOISE ID
83709-1050
US

IV. Provider business mailing address

105 S FRANKLIN PARK DR
BOISE ID
83709-1050
US

V. Phone/Fax

Practice location:
  • Phone: 208-761-4828
  • Fax:
Mailing address:
  • Phone: 208-761-4828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE LINCOLN
Title or Position: OWNER
Credential: LPC
Phone: 208-761-4828