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Organization

OBSIDIAN COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YESENIA IBARRA TREJO LCSW (OWNER)
(208) 244-6799
Entity
Organization

Contact information

Practice address
200 S MAIN ST STE P1, POCATELLO, ID 83204-3261
(208) 244-6799
(208) 274-9407
Mailing address
200 S MAIN ST STE P1, POCATELLO, ID 83204-3261
(208) 244-6799
(208) 274-9407

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
06/04/2025
Last updated
06/04/2025
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