Healthcare Provider Details

I. General information

NPI: 1942808019
Provider Name (Legal Business Name): HELPING HEARTS COUNSELING CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 10/12/2020
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CLEVELAND BLVD
CALDWELL ID
83605-3624
US

IV. Provider business mailing address

310 CLEVELAND BLVD # 310
CALDWELL ID
83605-3624
US

V. Phone/Fax

Practice location:
  • Phone: 120-895-4059
  • Fax:
Mailing address:
  • Phone: 208-954-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. YOLANDA AMBER PONDER
Title or Position: CEO, CLINICAL DIRECTOR/THERAPIST
Credential: LCSW
Phone: 208-954-0597