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General NPI Number Information
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NPI Number | 1326721598
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Entity Type | Organization
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Legal Business Name | RESILIENT CONNECTIONS COUNSELING PLLC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 758 W WILDRYE CT
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City | NAMPA
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State | ID
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Zip | 83686-4919
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Country | US
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Telephone | 253-279-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 758 W WILDRYE CT
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City | NAMPA
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State | ID
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Zip | 83686-4919
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Country | US
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Telephone | 253-279-6886
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICIAN
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Name | STEPHANIE WITT
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Credential | LCPC, LMHC
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Telephone | 253-279-6886
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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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