Healthcare Provider Details

I. General information

NPI: 1568952497
Provider Name (Legal Business Name): MARSHA MCCURDY LCPC-8208
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13403 N GOVT WAY STE 202
HAYDEN ID
83835-8911
US

IV. Provider business mailing address

13403 N GOVT WAY STE 202
HAYDEN ID
83835-8911
US

V. Phone/Fax

Practice location:
  • Phone: 208-518-1250
  • Fax:
Mailing address:
  • Phone: 208-518-1250
  • Fax: 208-518-2712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC6864
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-8208
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLCPC-8208
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: