MEDICARE: ROCKY MOUNTAIN COUNSELING & NEUROFEEDBACK CENTER

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1407718695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKY MOUNTAIN COUNSELING & NEUROFEEDBACK CENTER

Provider Business Mailing Address
First Line	:	221 W MAIN ST
Second Line	:
City	:	GRANGEVILLE
State	:	ID
Zip	:	83530-1901
Country	:	US
Telephone Number	:	208-581-4383
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 W MAIN ST STE 8
Second Line	:
City	:	GRANGEVILLE
State	:	ID
Zip	:	83530-1901
Country	:	US
Telephone Number	:	208-581-4383
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAYLA DAWNE SALISBURY
Credential	:	LPC
Telephone Number	:	208-553-5344

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	05/30/2026

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