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General NPI Number Information
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NPI Number | 1609676444
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Entity Type | Organization
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Legal Business Name | EVER FORWARD COUNSELING X NEUROFEEDBACK
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 6001 W STATE ST STE D
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City | BOISE
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State | ID
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Zip | 83703-6428
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Country | US
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Telephone | 208-398-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 W HENDRICKS CT
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City | MERIDIAN
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State | ID
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Zip | 83646-1335
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Country | US
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Telephone | 208-861-2008
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Fax |
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Authorized Official
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Title or Position | CEO, COUNSELOR
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Name | MONIQUE BARBER
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Credential | PHD
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Telephone | 208-861-2008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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