=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467248799
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELINDA GAMBOA COUNSELING AND CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2025
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2995 N COLE RD
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83704-5964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-918-1554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2995 N COLE RD STE 225
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83704-5966
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-918-1554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BELINDA GAMBOA
-----------------------------------------------------
Credential | M. COUN, LCPC
-----------------------------------------------------
Telephone | 208-918-1554
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------