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General NPI Number Information
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NPI Number | 1801274790
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Entity Type | Organization
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Legal Business Name | INTEGRATED COUNSELING AND WELLNESS OF REXBURG
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 101 E MAIN ST STE 210
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City | REXBURG
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State | ID
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Zip | 83440-2017
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Country | US
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Telephone | 208-357-3104
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Fax | 888-990-2826
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Provider Business Mailing Address
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Address Line | 101 E MAIN ST STE 210
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City | REXBURG
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State | ID
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Zip | 83440-2017
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Country | US
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Telephone | 208-357-3104
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Fax | 888-990-2826
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LUKE EINERSON
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Credential | PHD, LAMFT
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Telephone | 208-357-3104
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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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