Healthcare Provider Details

I. General information

NPI: 1174341820
Provider Name (Legal Business Name): RESISTANCE AND RESILIENCE COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 1/2 S MAIN ST
HAILEY ID
83333-8403
US

IV. Provider business mailing address

PO BOX 3410
HAILEY ID
83333-3410
US

V. Phone/Fax

Practice location:
  • Phone: 281-386-9054
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY MYRICK
Title or Position: MANAGING MEMBER
Credential:
Phone: 281-386-9054