Provider Demographics
NPI:1386402097
Name:MINDFUL AWARENESS COUNSELING
Entity type:Organization
Organization Name:MINDFUL AWARENESS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:NEEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-670-0290
Mailing Address - Street 1:628 W TERN DR
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-2994
Mailing Address - Country:US
Mailing Address - Phone:208-670-0290
Mailing Address - Fax:
Practice Address - Street 1:628 W TERN DR
Practice Address - Street 2:
Practice Address - City:KUNA
Practice Address - State:ID
Practice Address - Zip Code:83634-2994
Practice Address - Country:US
Practice Address - Phone:208-670-0290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center