Healthcare Provider Details

I. General information

NPI: 1770492365
Provider Name (Legal Business Name): SARAH WALSH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E RIVERPARK LN STE 215
BOISE ID
83706-6562
US

IV. Provider business mailing address

600 E RIVERPARK LN STE 215
BOISE ID
83706-6562
US

V. Phone/Fax

Practice location:
  • Phone: 303-495-8063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4281230
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: