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General NPI Number Information
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NPI Number | 1558212761
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Entity Type | Organization
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Legal Business Name | COURAGE TO TALK THERAPEUTIC COUNSELING CENTER PLLC
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 1883 N WILDWOOD ST STE B
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City | BOISE
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State | ID
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Zip | 83713-5146
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Country | US
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Telephone | 208-484-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 4954 N WILD GOOSE WAY # A
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City | MERIDIAN
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State | ID
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Zip | 83646-5988
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Country | US
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Telephone | 208-484-0920
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | HEIDI SENETHAVILAY
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Credential | PH.D
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Telephone | 208-484-0920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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