Healthcare Provider Details

I. General information

NPI: 1912059031
Provider Name (Legal Business Name): JOYCE FAYE YEAGER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W IOWA AVE
NAMPA ID
83686-2834
US

IV. Provider business mailing address

PO BOX 1662
MERIDIAN ID
83680-1662
US

V. Phone/Fax

Practice location:
  • Phone: 208-315-6717
  • Fax: 208-315-6718
Mailing address:
  • Phone: 208-315-6717
  • Fax: 208-315-6718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19633
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-4792
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: