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General NPI Number Information
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NPI Number | 1992663744
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Entity Type | Organization
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Legal Business Name | ASPEN TRAIL COUNSELING LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 4696 W OVERLAND RD STE 268
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City | BOISE
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State | ID
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Zip | 83705-2877
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Country | US
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Telephone | 208-629-7894
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Fax | 208-473-7317
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Provider Business Mailing Address
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Address Line | 4696 W OVERLAND RD STE 268
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City | BOISE
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State | ID
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Zip | 83705-2877
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Country | US
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Telephone | 208-629-7894
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Fax | 208-473-7317
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Authorized Official
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Title or Position | OWNER PRACTICTIONER
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Name | CRYSTAL MAUST
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Credential | LCPC
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Telephone | 208-789-6826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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