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General NPI Number Information
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NPI Number | 1902669740
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Entity Type | Organization
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Legal Business Name | KYLEY J. TRAUSCH, LCSW LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 403 W CHERRY LN
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City | MERIDIAN
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State | ID
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Zip | 83642-1610
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Country | US
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Telephone | 208-502-8185
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Fax | 208-900-1698
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Provider Business Mailing Address
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Address Line | 6299 N EAGLE RD # 1005
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City | BOISE
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State | ID
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Zip | 83713-0955
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Country | US
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Telephone | 208-502-8185
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Fax | 208-900-1698
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MS. KYLEY JO TRAUSCH
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Credential | LCSW
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Telephone | 208-502-8185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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