MEDICARE: HAUDER SERVICES LTD

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	106H00000X	Marriage & Family Therapist	LMFT2844	ID
2	101YP2500X	Professional Counselor	LCPC52	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000010016724	OTHER	ID	BLUE SHIELD
2	Q4624	OTHER	ID	BLUE CROSS

General Provider Information

NPI Number	:	1841302171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAUDER SERVICES LTD

Provider Business Mailing Address
First Line	:	1674 HILL RD
Second Line	:	STE 14
City	:	BOISE
State	:	ID
Zip	:	83702-0958
Country	:	US
Telephone Number	:	208-336-0200
Fax Number	:	208-336-3837

Provider Business Practice Location Address
First Line	:	1674 HILL RD
Second Line	:	STE 14
City	:	BOISE
State	:	ID
Zip	:	83702-0958
Country	:	US
Telephone Number	:	208-336-0200
Fax Number	:	208-336-3837

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. REBECCA S HAUDER
Credential	:	LCPC LMFT
Telephone Number	:	208-336-0200

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	09/11/2025

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Directions to “HAUDER SERVICES LTD ” Practice Location

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