Healthcare Provider Details

I. General information

NPI: 1891246054
Provider Name (Legal Business Name): GAIL MARIE WARD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 01/08/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

INSIGHT COUNSELING AND THERAPY 250 S MAIN ST
PAYETTE ID
83661
US

IV. Provider business mailing address

1273 SPRING CREEK LANE UNIT 210
FRUITLAND ID
83619
US

V. Phone/Fax

Practice location:
  • Phone: 208-405-0020
  • Fax: 208-466-5058
Mailing address:
  • Phone: 541-556-8848
  • Fax: 208-466-5058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number509591
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMAC
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6349
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: