MEDICARE: BEYOUTIFY THE MIND 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558214627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOUTIFY THE MIND COUNSELING PLLC

Provider Business Mailing Address
First Line	:	2976 E STATE ST.
Second Line	:	STE 120 UNIT #2079
City	:	EAGLE
State	:	ID
Zip	:	83616-6394
Country	:	US
Telephone Number	:	208-807-3270
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 AVIATION WAY SPC 45
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-1153
Country	:	US
Telephone Number	:	208-807-3270
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	DAWN MARIE KANGAS
Credential	:	LPC
Telephone Number	:	208-807-3270

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	06/01/2026

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