Individual
BRIAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
440 W PENNWOOD ST STE 100, MERIDIAN, ID 83642-8612
(208) 888-5905
(208) 888-5513
Mailing address
PO BOX 175, KUNA, ID 83634-0175
(986) 888-0116
(208) 888-5513
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-6635
ID
101YM0800X
Mental Health Counselor
LPC-5600
ID
Other
Enumeration date
07/30/2014
Last updated
01/19/2023
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