Healthcare Provider Details

I. General information

NPI: 1952818692
Provider Name (Legal Business Name): CHRISTOPHER DEMING LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3071 E FRANKLIN RD # 201
MERIDIAN ID
83642-2376
US

IV. Provider business mailing address

10753 W GILA DR
KUNA ID
83634-2639
US

V. Phone/Fax

Practice location:
  • Phone: 208-807-2877
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8851941
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8851941
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: