Healthcare Provider Details

I. General information

NPI: 1699537423
Provider Name (Legal Business Name): CULTIVATING CONNECTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N 3RD ST STE 7
MCCALL ID
83638-4406
US

IV. Provider business mailing address

PO BOX 188
MCCALL ID
83638-0188
US

V. Phone/Fax

Practice location:
  • Phone: 208-462-0802
  • Fax: 208-460-0055
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY BROWN
Title or Position: OWNER
Credential: LCSW
Phone: 208-462-0802