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General NPI Number Information
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NPI Number | 1215727581
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Entity Type | Organization
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Legal Business Name | ROSEWOOD THERAPY LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 3350 W AMERICANA TER STE 320
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City | BOISE
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State | ID
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Zip | 83706-2548
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Country | US
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Telephone | 208-608-3587
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Fax |
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Provider Business Mailing Address
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Address Line | 8650 W RIFLEMAN ST APT B201
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City | BOISE
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State | ID
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Zip | 83704-8381
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Country | US
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Telephone | 208-240-1333
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | SYDNEY ROSE WILLIAMSON
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Credential | LPC
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Telephone | 208-240-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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