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General NPI Number Information
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NPI Number | 1205773124
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Entity Type | Organization
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Legal Business Name | WHOLEHEARTED JOURNEY COUNSELING LLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 801 PINE ST STE A
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City | SANDPOINT
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State | ID
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Zip | 83864-1682
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Country | US
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Telephone | 208-290-6604
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 271
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City | SAGLE
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State | ID
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Zip | 83860-0271
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Country | US
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Telephone | 208-290-6604
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Fax | 208-216-8055
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Authorized Official
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Title or Position | OWNER
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Name | AMBER RENEE HENRICKSON
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Credential | LCSW
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Telephone | 208-290-6604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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