Individual
SAMANTHA CICERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6305 W OVERLAND RD, BOISE, ID 83709-3029
(208) 559-0410
Mailing address
6305 W OVERLAND RD, BOISE, ID 83709-3029
(208) 559-0410
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8331513
ID
251S00000X
Community/Behavioral Health Agency
LPC-9479
ID
Other
Enumeration date
05/23/2023
Last updated
06/26/2025
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