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Individual

ADAM RAY BURWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
1799 N LAKES PL, MERIDIAN, ID 83646-1833
(208) 888-5905
Mailing address
1799 N LAKES PL, MERIDIAN, ID 83646-1833

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
COUI-8559
ID
101YM0800X
Mental Health Counselor
Primary
8331295
ID
101YM0800X
Mental Health Counselor
LPC-8743
ID

Other

Enumeration date
12/20/2021
Last updated
08/25/2024
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