Healthcare Provider Details

I. General information

NPI: 1043158025
Provider Name (Legal Business Name): TIMOTHY L STREIGHT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BURNSIDE AVE
MIDDLETON ID
83644-1141
US

IV. Provider business mailing address

555 BURNSIDE AVE
MIDDLETON ID
83644-1141
US

V. Phone/Fax

Practice location:
  • Phone: 208-695-3231
  • Fax:
Mailing address:
  • Phone: 208-695-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4671181
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: