Individual
MR. MICHAEL JOHN SCOVILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.COUN, LCPC
Contact information
Practice address
5185 W OVERLAND RD, BOISE, ID 83705-2635
(208) 985-8550
Mailing address
271 E LINMAR DR, KUNA, ID 83634-1479
(208) 392-7263
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-6304
ID
101YM0800X
Mental Health Counselor
LPC-5312
ID
101YP2500X
Professional Counselor
LPC-5312
ID
Other
Enumeration date
08/30/2013
Last updated
03/07/2024
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