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NPI 1114882818

NPI 1114882818 : DONNIE HARKINS CADC : BOISE, ID

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General NPI Number Information
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    NPI Number           |    1114882818
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    Entity Type          |    Individual 
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    Provider Name        |    DONNIE HARKINS CADC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/16/2025
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    Last Update Date     |    12/16/2025
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Provider Practice Location Address
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    Address Line         |    3663 N LAKEHARBOR LN 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83703-6913
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    Country              |    US
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    Telephone            |    208-286-4274
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    223 W WASHINGTON AVE 
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    City                 |    HOMEDALE
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    State                |    ID
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    Zip                  |    83628-3111
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    Country              |    US
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    Telephone            |    208-965-7093
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    CADC-5102
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    License Number State |    ID
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