Healthcare Provider Details

I. General information

NPI: 1871801548
Provider Name (Legal Business Name): BOBBI JO GEIGER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3153 EAST LOCUST STREET
EMMETT ID
83617
US

IV. Provider business mailing address

3153 E LOCUST ST.
EMMETT ID
83617
US

V. Phone/Fax

Practice location:
  • Phone: 208-570-5625
  • Fax:
Mailing address:
  • Phone: 208-570-5625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7939
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW 29970
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number29970
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: