# STATE OF MIND COUNSELING AND WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013277128
- **Authorized official:** LYNDA SMITH (LPC)
- **Authorized official phone:** (208) 602-2293

## Contact information

- **Practice address:** 141 N PALMETTO AVE UNIT 1626, EAGLE, ID 83616-8066
- **Practice address phone:** (208) 939-3999
- **Mailing address:** 233 W STATE ST STE D, EAGLE, ID 83616-4982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | 4841 | ID | — |
| 261QM0850X | Adult Mental Health Clinic/Center | 4841 | ID | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 4841 | ID | Yes |

## Other

- **Enumeration date:** 05/22/2012
- **Last updated:** 07/27/2012