Individual
JEFFREY EASTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
2589 S FIVE MILE RD, BOISE, ID 83709-2325
(208) 841-4837
Mailing address
2861 N MULE DEER WAY, MERIDIAN, ID 83646-7813
(208) 509-0889
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-4825
ID
101YP2500X
Professional Counselor
88523
TX
101YP2500X
Professional Counselor
Primary
LCPC-5455
ID
Other
Enumeration date
12/12/2011
Last updated
03/01/2023
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