Organization
IDAHO COUNSELING AND TRAUMA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA K BAKER LMFT (OWNER)
(208) 278-6027
Entity
Organization
Contact information
Practice address
1309 PONDEROSA DR, SANDPOINT, ID 83864-8278
(208) 278-6027
Mailing address
204 N 4TH AVE UNIT 2423, SANDPOINT, ID 83864-0476
(208) 278-6027
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171400000X
Health & Wellness Coach
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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