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Individual

STEPHANIE HERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, CADC

Contact information

Practice address
1450 AVIATION DR STE 202, HAILEY, ID 83333-8785
(208) 727-8970
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8738

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
08/14/2013
Last updated
10/03/2017
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