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General NPI Number Information
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NPI Number | 1366212797
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Entity Type | Individual
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Provider Name | LAUREN ELISE SMITH MS
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Gender | Female
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 219 N 27TH ST STE 7
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City | BOISE
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State | ID
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Zip | 83702-4745
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Country | US
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Telephone | 208-274-3757
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Fax |
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Provider Business Mailing Address
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Address Line | 175 E 50TH ST
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City | GARDEN CITY
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State | ID
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Zip | 83714-1413
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Country | US
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Telephone | 208-274-3757
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Fax | 208-366-0574
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8461473
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License Number State | ID
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