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General NPI Number Information
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NPI Number | 1649959495
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Entity Type | Organization
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Legal Business Name | TREASURE VALLEY COUNSELING AND WELLNESS PLLC
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 3782 E AMITY AVE STE 105
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City | NAMPA
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State | ID
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Zip | 83687-8961
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Country | US
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Telephone | 208-870-7978
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Fax |
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Provider Business Mailing Address
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Address Line | 17484 N OWL PEAK AVE
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City | NAMPA
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State | ID
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Zip | 83687-7106
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Country | US
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Telephone | 208-870-7978
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA MARIE TOVAR
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Credential | LCSW
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Telephone | 208-870-7978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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