Healthcare Provider Details

I. General information

NPI: 1215689849
Provider Name (Legal Business Name): BARBARA HINDERLIE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6807 CODY ST
BONNERS FERRY ID
83805-8613
US

IV. Provider business mailing address

6807 CODY ST
BONNERS FERRY ID
83805-8613
US

V. Phone/Fax

Practice location:
  • Phone: 208-267-0900
  • Fax:
Mailing address:
  • Phone: 208-267-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMSW-41678
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-45178
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: