Healthcare Provider Details

I. General information

NPI: 1598643728
Provider Name (Legal Business Name): THE NATURE OF MIND-BODY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WELLINGTON PL
HOPE ID
83836-8709
US

IV. Provider business mailing address

321 OSPREY CIR
HOPE ID
83836-9626
US

V. Phone/Fax

Practice location:
  • Phone: 208-718-2311
  • Fax:
Mailing address:
  • Phone: 906-458-5337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE RAY
Title or Position: THERAPIST
Credential: LCSW
Phone: 208-718-2311