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General NPI Number Information
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NPI Number | 1679497911
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Entity Type | Organization
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Legal Business Name | ANCHOR AND SOUL COUNSELING LLC
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 1800 GARRETT WAY STE 19
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City | POCATELLO
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State | ID
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Zip | 83201-5132
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Country | US
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Telephone | 208-417-1541
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Fax |
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Provider Business Mailing Address
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Address Line | 5033 HAWTHORNE RD APT 15
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City | CHUBBUCK
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State | ID
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Zip | 83202-2261
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Country | US
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Telephone | 208-269-0601
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | NICHOLAS DAVIS
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Credential | LPC
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Telephone | 208-269-0601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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