Organization
CENTRAL IDAHO COUNSELING, PLLC
Active
Other names
Central Idaho Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC A MIKKELSEN LMFT (OWNER/CLINICIAN)
(208) 634-2962
Entity
Organization
Contact information
Practice address
125 COMMERCE ST., SUITE B, MCCALL, ID 83638
(208) 634-2962
(208) 634-5064
Mailing address
125 COMMERCE ST., SUITE B, MCCALL, ID 83638
(208) 634-2962
(208) 634-5064
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20002621
PROVIDER TRANSACTION ACCESS NUMBER
ID
05
—
488228600C1
—
ID
Enumeration date
05/09/2014
Last updated
01/21/2025
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