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General NPI Number Information
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NPI Number | 1558801589
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Entity Type | Organization
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Legal Business Name | ANOTHER CHANCE COUNSELING, PLLC
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 6126 W STATE ST STE 109
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City | BOISE
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State | ID
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Zip | 83703-2741
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Country | US
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Telephone | 208-850-9846
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Fax | 208-321-5539
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Provider Business Mailing Address
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Address Line | 6126 W STATE ST STE 109
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City | BOISE
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State | ID
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Zip | 83703-2741
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Country | US
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Telephone | 208-850-9846
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Fax | 208-321-5539
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | MS. SUZANNE BUCHANAN
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Credential | LCSW
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Telephone | 208-850-9846
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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 | LCSW21765
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License Number State | ID
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