Healthcare Provider Details

I. General information

NPI: 1841113859
Provider Name (Legal Business Name): MORINGA MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 E BLUE TICK ST
MERIDIAN ID
83642-4547
US

IV. Provider business mailing address

1941 E BLUE TICK ST
MERIDIAN ID
83642-4547
US

V. Phone/Fax

Practice location:
  • Phone: 208-283-1443
  • Fax: 208-283-1443
Mailing address:
  • Phone: 208-283-1443
  • Fax: 208-283-1443

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: KARA MARIE KREIZENBECK
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 208-283-1443