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General NPI Number Information
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NPI Number | 1063762672
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Entity Type | Organization
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Legal Business Name | TRUE NORTH COUNSELING, LLC
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 100 MAIN STREET SUITE 203
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City | BOISE
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State | ID
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Zip | 83702
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Country | US
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Telephone | 208-918-6466
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MAIN STREET SUITE 203
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City | BOISE
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State | ID
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Zip | 83702
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Country | US
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Telephone | 208-918-6466
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DAVID NICHOLS
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Credential | LPC
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Telephone | 208-918-6466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-5048
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License Number State | ID
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