Healthcare Provider Details

I. General information

NPI: 1104498229
Provider Name (Legal Business Name): JANINA DOWDY, LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N LAKES PL STE 100
MERIDIAN ID
83646-1906
US

IV. Provider business mailing address

2534 N COUNTRYSIDE AVE
KUNA ID
83634-2503
US

V. Phone/Fax

Practice location:
  • Phone: 208-891-2853
  • Fax:
Mailing address:
  • Phone: 208-891-2853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANINA L DOWDY
Title or Position: OWNER
Credential:
Phone: 208-891-2853