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General NPI Number Information
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NPI Number | 1881308427
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Entity Type | Individual
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Provider Name | LENA ACOSTA LPC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 7201 W FRANKLIN RD
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City | BOISE
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State | ID
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Zip | 83709-0926
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Country | US
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Telephone | 208-350-7497
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Fax |
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Provider Business Mailing Address
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Address Line | 4072 E ARCH DR
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City | MERIDIAN
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State | ID
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Zip | 83646-7390
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Country | US
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Telephone | 310-986-7099
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Fax |
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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 | LPC-8191
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License Number State | ID
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