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Organization

CALDWELL COUNSELING ASSOCIATES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LYNDELL V. JACKSON LCPC (OWNER COUNSELOR)
(208) 880-6127
Entity
Organization

Contact information

Practice address
2020 BLAINE ST, CALDWELL, ID 83605-4343
(208) 880-6127
(208) 455-6244
Mailing address
2020 BLAINE ST, CALDWELL, ID 83605-4343
(208) 880-6127
(208) 455-6244

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC234
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010016363
REGENCE BLUE SHIELD OF ID
ID
01
Q1109
BLUE CROSS OF ID
ID
Enumeration date
11/29/2006
Last updated
08/22/2020
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