Healthcare Provider Details

I. General information

NPI: 1881425098
Provider Name (Legal Business Name): SHELBY SPANGLER COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 11TH AVE S STE 204
NAMPA ID
83651-5074
US

IV. Provider business mailing address

320 11TH AVE S STE 204
NAMPA ID
83651-5074
US

V. Phone/Fax

Practice location:
  • Phone: 208-477-7291
  • Fax:
Mailing address:
  • Phone: 208-477-7291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHELBY ANN SPANGLER
Title or Position: ADMINISTRATOR
Credential: LCPC
Phone: 208-477-7291