Organization
CROSS CREEK COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA M GOODRICH LMFT (OWNER)
(208) 863-0045
Entity
Organization
Contact information
Practice address
1047 S WELLS ST, MERIDIAN, ID 83642-7997
(208) 863-0045
Mailing address
1047 S WELLS ST, MERIDIAN, ID 83642-7997
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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