Healthcare Provider Details

I. General information

NPI: 1275460743
Provider Name (Legal Business Name): STILLWIND COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 FAIR ST
BUHL ID
83316-6442
US

IV. Provider business mailing address

PO BOX 105
BUHL ID
83316-0105
US

V. Phone/Fax

Practice location:
  • Phone: 208-539-0496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KENDYL KISSELL
Title or Position: OWNER
Credential: LCPC
Phone: 208-539-0496