Healthcare Provider Details

I. General information

NPI: 1821673716
Provider Name (Legal Business Name): SUMMIT VIEW WELLNESS SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 HILINE RD STE 250
POCATELLO ID
83201-2955
US

IV. Provider business mailing address

1070 HILINE RD STE 250
POCATELLO ID
83201-2955
US

V. Phone/Fax

Practice location:
  • Phone: 208-262-4209
  • Fax: 208-262-4318
Mailing address:
  • Phone: 208-262-4209
  • Fax: 208-262-4318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TRENT P TURNER
Title or Position: OWNER/MEMBER
Credential: LCSW
Phone: 208-262-4209