Healthcare Provider Details

I. General information

NPI: 1083016992
Provider Name (Legal Business Name): DIANA LINCOLN-HAYE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 CENTER ST E
KIMBERLY ID
83341-1809
US

IV. Provider business mailing address

403 CENTER ST E
KIMBERLY ID
83341-1809
US

V. Phone/Fax

Practice location:
  • Phone: 208-731-7646
  • Fax: 208-955-9049
Mailing address:
  • Phone: 208-731-7646
  • Fax: 208-576-6904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-5605
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: