Healthcare Provider Details

I. General information

NPI: 1568306694
Provider Name (Legal Business Name): NITAI TRUENORTH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 N NEBULA AVE
STAR ID
83669-5474
US

IV. Provider business mailing address

784 S CLEARWATER LOOP
POST FALLS ID
83854-9599
US

V. Phone/Fax

Practice location:
  • Phone: 208-903-2640
  • Fax:
Mailing address:
  • Phone: 208-903-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DONNELLE ADRIAN HAUN
Title or Position: PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 808-270-0390