Healthcare Provider Details

I. General information

NPI: 1639868474
Provider Name (Legal Business Name): SEED WORK COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2322 POLK ST
CALDWELL ID
83605-2357
US

IV. Provider business mailing address

2322 POLK ST
CALDWELL ID
83605-2357
US

V. Phone/Fax

Practice location:
  • Phone: 208-304-2906
  • Fax:
Mailing address:
  • Phone: 208-304-2906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA CHILCOTT
Title or Position: OWNER
Credential: LCSW
Phone: 208-304-2906