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General NPI Number Information
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NPI Number | 1639956303
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Entity Type | Organization
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Legal Business Name | HEALING RAIN COUNSELING, PLLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 750 W USTICK RD STE 120
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City | MERIDIAN
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State | ID
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Zip | 83646-6133
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Country | US
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Telephone | 208-506-0520
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Fax | 208-391-2226
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Provider Business Mailing Address
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Address Line | 750 W USTICK RD STE 120
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City | MERIDIAN
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State | ID
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Zip | 83646-6133
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Country | US
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Telephone | 208-506-0520
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Fax | 208-391-2226
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Authorized Official
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Title or Position | OWNER
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Name | SHELBY MARTINI
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Credential | LPC
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Telephone | 208-506-0520
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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 |
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License Number State |
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