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General NPI Number Information
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NPI Number | 1215892690
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Entity Type | Organization
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Legal Business Name | A TIME FOR CHANGE THERAPY
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 737 W 18TH ST
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City | BURLEY
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State | ID
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Zip | 83318-2206
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Country | US
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Telephone | 208-568-5348
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Fax |
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Provider Business Mailing Address
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Address Line | 737 W 18TH ST
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City | BURLEY
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State | ID
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Zip | 83318-2206
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Country | US
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Telephone | 208-568-5348
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | TABATHA J BAUMGARTNER
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Credential | LCSW
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Telephone | 208-219-9196
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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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