NPI 1013277128

State of Mind Counseling and Wellness Center

Organisation Adolescent and Children Mental Health Clinic/Center Eagle, ID

Practice location

Address: 141 N Palmetto Ave Unit 1626, Eagle, ID 83616-8066
Phone: (208) 939-3999
Mailing address: 233 W State St STE D, Eagle, ID 83616-4982

Authorised official

Name: Lynda Smith
Title: Lpc
Phone: (208) 602-2293

Registered specialties (3)

Adolescent and Children Mental Health Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QM0855X Licence 4841 (ID)

Other Clinic/Center providers in Idaho →

Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X Licence 4841 (ID)

Other Community/Behavioral Health providers in Idaho →

Adult Mental Health Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM0850X Licence 4841 (ID)

Registry record

NPI: 1013277128
Entity type: Organization
NPI issued: 22 May 2012
Record last updated: 27 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.