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General NPI Number Information
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NPI Number | 1689922841
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Entity Type | Individual
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Provider Name | JANE SHARER DUKE M.COUN.,LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/20/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 10257 N PALISADES WAY
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City | BOISE
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State | ID
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Zip | 83714-9503
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Country | US
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Telephone | 208-939-5866
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Fax | 208-853-0939
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Provider Business Mailing Address
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Address Line | 6126 W STATE ST SUITE 306
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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 | 208-866-9584
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Fax | 208-853-0939
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LCPC #162
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC #162
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License Number State | ID
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