Healthcare Provider Details

I. General information

NPI: 1386778959
Provider Name (Legal Business Name): SEQUOIA COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 BRYDEN AVE
LEWISTON ID
83501-4438
US

IV. Provider business mailing address

PO BOX 1895 531 BRYDEN AVE
LEWISTON ID
83501-1463
US

V. Phone/Fax

Practice location:
  • Phone: 208-798-1646
  • Fax: 208-798-5568
Mailing address:
  • Phone: 208-798-1646
  • Fax: 208-798-5568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRENDA LEE MCKENZIE
Title or Position: CLINICAL DIRECTOR/OWNER
Credential: LCPC
Phone: 208-798-1646