MEDICARE: ASPEN TRAIL COUNSELING LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1992663744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN TRAIL COUNSELING LLC

Provider Business Mailing Address
First Line	:	4696 W OVERLAND RD STE 268
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83705-2877
Country	:	US
Telephone Number	:	208-629-7894
Fax Number	:	208-473-7317

Provider Business Practice Location Address
First Line	:	4696 W OVERLAND RD STE 268
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83705-2877
Country	:	US
Telephone Number	:	208-629-7894
Fax Number	:	208-473-7317

Authorized Official
Title or Position	:	OWNER PRACTICTIONER
Name	:	CRYSTAL MAUST
Credential	:	LCPC
Telephone Number	:	208-789-6826

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	03/06/2026

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Directions to “ASPEN TRAIL COUNSELING LLC ” Practice Location

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