Healthcare Provider Details

I. General information

NPI: 1568544047
Provider Name (Legal Business Name): KUNA COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E DEER FLAT RD
KUNA ID
83634-1323
US

IV. Provider business mailing address

145 E DEER FLAT RD
KUNA ID
83634-1323
US

V. Phone/Fax

Practice location:
  • Phone: 208-922-9001
  • Fax: 208-922-3778
Mailing address:
  • Phone: 208-922-9001
  • Fax: 208-922-3778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-407
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES ANDERSON GRIGG
Title or Position: OWNER
Credential:
Phone: 208-922-9001