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General NPI Number Information
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NPI Number | 1437519766
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Entity Type | Individual
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Provider Name | STEPHANIE CROSS
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Gender | Female
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 704 ABANY ST SUITE 3
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City | CALDWELL
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State | ID
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Zip | 83605
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Country | US
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Telephone | 208-603-4656
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Fax | 208-228-8688
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Provider Business Mailing Address
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Address Line | 10592 HOT SPRINGS AVE
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City | NAMPA
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State | ID
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Zip | 83687-5770
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Country | US
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Telephone | 208-989-2560
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Fax |
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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 | LCPC-7017
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC-7017
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License Number State | ID
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