MEDICARE: MINDFUL GLIMMER COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1235089947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL GLIMMER COUNSELING PLLC

Provider Business Mailing Address
First Line	:	16674 N PROFIT CIR STE 101
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83687-5243
Country	:	US
Telephone Number	:	208-654-8438
Fax Number	:

Provider Business Practice Location Address
First Line	:	16674 N PROFIT CIR STE 101
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83687-5243
Country	:	US
Telephone Number	:	208-654-8438
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER/THERAPIST
Name	:	MARIAH JOHNS GARCIA
Credential	:	LCSW
Telephone Number	:	208-654-8438

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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