Healthcare Provider Details

I. General information

NPI: 1285547968
Provider Name (Legal Business Name): MOUNTAIN HEALING COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 TREATY HWY
POCATELLO ID
83202-7051
US

IV. Provider business mailing address

346 TREATY HWY
POCATELLO ID
83202-7051
US

V. Phone/Fax

Practice location:
  • Phone: 208-221-9854
  • Fax:
Mailing address:
  • Phone: 208-221-9854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KARI YVONNE WOLBERT
Title or Position: OWNER
Credential: LPC CADC
Phone: 208-221-9854