=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255065983
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA MAY HOLDEN LCPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2022
-----------------------------------------------------
Last Update Date | 02/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3350 W AMERICANA TER # 100C
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83706-2521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-277-0365
-----------------------------------------------------
Fax | 208-723-2213
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3370 N FRONTIER WAY
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83713-3846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-277-0365
-----------------------------------------------------
Fax | 208-723-2213
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 8331329
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------